Healthcare Provider Details

I. General information

NPI: 1346509346
Provider Name (Legal Business Name): JAIME BRAVERMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2012
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5721 S MARYLAND AVE MC8016, K155
CHICAGO IL
60637-1425
US

IV. Provider business mailing address

5721 S MARYLAND AVE MC8016, K155
CHICAGO IL
60637-1425
US

V. Phone/Fax

Practice location:
  • Phone: 888-824-0200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036.137790
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number036137790
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: