Provider Demographics
NPI:1750518536
Name:BRAUER, MEREDITH HELEN (MD)
Entity type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:HELEN
Last Name:BRAUER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MEREDITH
Other - Middle Name:HELEN
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:25 N WINFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1295
Mailing Address - Country:US
Mailing Address - Phone:630-933-4700
Mailing Address - Fax:630-933-4427
Practice Address - Street 1:25 N WINFIELD RD
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1295
Practice Address - Country:US
Practice Address - Phone:630-933-4700
Practice Address - Fax:630-933-4427
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL4055477207R00000X
IL036130045208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400093830OtherMEDICARE (INDIVIDUAL)
IL036130045OtherMEDICAID
ILP01239424OtherMEDICARE RAILROAD PTAN (INDIVIDUAL)
IL206147OtherMEDICARE (GROUP)
ILCE8792OtherMEDICARE RAILROAD PTAN (GROUP)