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General NPI Number Information
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NPI Number | 1912542226
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Entity Type | Organization
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Legal Business Name | BRAVI HEALTH LIMITED
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Dates
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Enumeration Date | 11/11/2019
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Last Update Date | 11/11/2019
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Provider Practice Location Address
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Address Line | 645 N MICHIGAN AVE STE 543
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City | CHICAGO
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State | IL
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Zip | 60611-2881
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Country | US
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Telephone | 312-521-0064
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Fax |
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Provider Business Mailing Address
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Address Line | 5208 N WINTHROP AVE APT 2
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City | CHICAGO
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State | IL
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Zip | 60640-2358
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Country | US
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Telephone | 773-407-2050
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LORI BRAVI
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Credential | OTR
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Telephone | 773-407-2050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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