Healthcare Provider Details

I. General information

NPI: 1245299031
Provider Name (Legal Business Name): CHARANJIT K BRAR RN, ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JBVA MEDICAL CENTER 820 S DAMEN AVE
CHICAGO IL
60608
US

IV. Provider business mailing address

6437 DAVANE CT
DOWNERS GROVE IL
60516-3057
US

V. Phone/Fax

Practice location:
  • Phone: 312-569-6618
  • Fax: 312-569-7346
Mailing address:
  • Phone: 630-960-3603
  • Fax: 312-569-7346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number41259486
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: