Provider Demographics
NPI:1891157632
Name:BREMER, KHIN KHIN (MD)
Entity Type:Individual
Prefix:
First Name:KHIN KHIN
Middle Name:
Last Name:BREMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3825 HIGHLAND AVENUE
Mailing Address - Street 2:TOWER 1, SUITE #5H-5M
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515
Mailing Address - Country:US
Mailing Address - Phone:630-275-9060
Mailing Address - Fax:630-275-9065
Practice Address - Street 1:3825 HIGHLAND AVENUE
Practice Address - Street 2:TOWER 1, SUITE# 5H-5M
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515
Practice Address - Country:US
Practice Address - Phone:630-275-9060
Practice Address - Fax:630-275-9065
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.148118208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics