Physician Compare National (NPI:1205945425)

HEALTHCARE PROVIDER: NATHAN ALAN BRAVERMAN D.M.D., M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1205945425
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7719135177
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120911000774
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BRAVERMAN
	Individual professional last name
Provider First Name	NATHAN
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NORTHWESTERN UNIVERSITY WOMANS MEDICAL SCHOOL
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	MAXILLOFACIAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	ORAL SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	ORAL SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	1770 1ST ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 350
	Group Practice or individual's line 2 address
City	HIGHLAND PARK
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	600355601
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140281
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NORTHWESTERN MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	140130
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	NORTHWESTERN LAKE FOREST HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	M