Healthcare Provider Details

I. General information

NPI: 1851234256
Provider Name (Legal Business Name): BRITEWELL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1913 CRESTVIEW DR
PLAINFIELD IL
60586-4126
US

IV. Provider business mailing address

1913 CRESTVIEW DR
PLAINFIELD IL
60586-4126
US

V. Phone/Fax

Practice location:
  • Phone: 815-955-8323
  • Fax:
Mailing address:
  • Phone: 815-955-8323
  • Fax: 815-782-4007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. BRIGHT BORKORM
Title or Position: PRESIDENT
Credential:
Phone: 815-955-8323