MEDICARE: BRIGHAM R TEMPLE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	86873	WI
2	207P00000X	Emergency Medicine Physician	036-108629	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528134038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIGHAM R TEMPLE MD

Provider Business Mailing Address
First Line	:	2650 RIDGE AVE
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1700
Country	:	US
Telephone Number	:	847-570-1206
Fax Number	:	847-570-1248

Provider Business Practice Location Address
First Line	:	2650 RIDGE AVE
Second Line	:	EMERGENCY MEDICINE RM G909
City	:	EVANSTON
State	:	IL
Zip	:	60201-1718
Country	:	US
Telephone Number	:	847-570-2114
Fax Number	:	847-570-1223

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2006
Last Update Date	:	04/29/2026

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Directions to “ BRIGHAM R TEMPLE MD” Practice Location

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