BRENT T. FONNER (M.D.) – Diagnostic Radiology Physician, NPI 1477555308

BRENT T. FONNER (M.D.) is a healthcare provider. based in Lombard, Illinois. specializing in DIAGNOSTIC RADIOLOGY. They hold the professional credentials M.D.. They hold a License No. 036088383 (IL). The NPI Number for BRENT T. FONNER (M.D.) is 1477555308

Main info

Male
35 Years Of Experience
Accepts Medicare Assignment
Name
BRENT T. FONNER (M.D.)
NPI
1477555308
Phone
(630) 874-2542
Address
520 E 22ND ST
Enumeration Date
11 August 2005
Last Update Date
13 May 2008

Doctor Profile

Medical School Name
NORTHWESTERN UNIVERSITY FEINBERG MEDICAL SCHOOL
Secondary Phone
8477232210
Graduation Year
1991 (35 years ago)
PAC ID
0244221083
Group Practice PAC ID
2567784408
Professional Enrollment ID
I20040520001087
Address ID
IL600681143PA1775XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

2,121 DIAGNOSTIC RADIOLOGY in IL

Provider Addresses for BRENT T. FONNER (M.D.)

  • 520, East 22nd Street, Highland Hills, Lombard, DuPage County, Illinois, 60148, United States

    LOMBARD, IL 601486110

    Phone: (630) 874-2542

    Fax: (630) 874-2642

    Type: Mailing

  • PROVENA MERCY MEDICAL CENTER / PATHOLOGY DEPARTMENT

    1325 NORTH HIGHLAND AVENUE

    AURORA, IL 60506

    Phone: (630) 859-2222

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-05-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040520001087IDiagnostic RadiologyILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
Q9967Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml3,25136$0
A9585Injection, gadobutrol, 0.1 ml2,22024$0
77067Screening mammography368368$0
77063Screening 3d breast mammography368368$0
71045X-ray of chest, 1 view254235$0
View full utilization report →

Insurance plans in this area (ZIP 60148)

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Provider's Procedures

BRENT T. FONNER (M.D.) performs procedures in DIAGNOSTIC RADIOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYIL71010X-ray of chest, 1 view, front409369
DIAGNOSTIC RADIOLOGYIL71250CT scan chest5049
DIAGNOSTIC RADIOLOGYIL73562X-ray of knee, 3 views1311
DIAGNOSTIC RADIOLOGYIL73630X-ray of foot, minimum of 3 views1817
DIAGNOSTIC RADIOLOGYIL74177CT scan of abdomen and pelvis with contrast3937
DIAGNOSTIC RADIOLOGYIL76830Ultrasound pelvis through vagina1313
DIAGNOSTIC RADIOLOGYIL93971Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers1212

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2567784408View full group profile
NameSpecialtyState
Diagnostic RadiologyIL
Diagnostic RadiologyIL
-IL
Diagnostic RadiologyIL
Diagnostic RadiologyIL
-IL
-IL
Diagnostic RadiologyIL
-IL
Diagnostic RadiologyIA

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Frequently asked questions

Is BRENT T. FONNER (M.D.) listed with a National Provider Identifier?
Yes — BRENT T. FONNER (M.D.) has NPI 1477555308 on file in the registry.
Would BRENT T. FONNER (M.D.) appear as active to a payer?
You can treat BRENT T. FONNER (M.D.) as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for BRENT T. FONNER (M.D.)?
At a glance, BRENT T. FONNER (M.D.) is tied to Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
Is BRENT T. FONNER (M.D.) associated with Lombard?
Public fields place BRENT T. FONNER (M.D.) around Lombard, Illinois. Always confirm the exact site before visiting.
Does BRENT T. FONNER (M.D.) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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