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NPI Code Detail

MEDICARE: BRAVO CARE OF NORTHBROOK INC

MEDICARE: BRAVO CARE OF NORTHBROOK INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1659568319
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRAVO CARE OF NORTHBROOK INC
Provider Business Mailing Address
First Line : 11701 BORMAN DR STE 315
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63146-4194
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4101 LAKE COOK RD
Second Line :
City : NORTHBROOK
State : IL
Zip : 60062-1112
Country : US
Telephone Number : 847-562-1770
Fax Number :
Authorized Official
Title or Position : AR DIRECTOR
Name : ALEKSANDRA SAVIC
Credential :
Telephone Number : 314-994-9070
Provider Enumeration Date : 09/26/2007
Last Update Date : 12/01/2016

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Directions to “BRAVO CARE OF NORTHBROOK INC ” Practice Location

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