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NPI Code Detail

MEDICARE: BRIGHTLAND HEALTH LLC

MEDICARE: BRIGHTLAND HEALTH LLC
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
12084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1952815656
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIGHTLAND HEALTH LLC
Provider Business Mailing Address
First Line : 800 W DIVERSEY PKWY STE 200
Second Line :
City : CHICAGO
State : IL
Zip : 60614-1412
Country : US
Telephone Number : 312-796-7121
Fax Number : 888-523-4767
Provider Business Practice Location Address
First Line : 800 W DIVERSEY PKWY STE 200
Second Line :
City : CHICAGO
State : IL
Zip : 60614-1412
Country : US
Telephone Number : 312-796-7121
Fax Number : 888-523-4767
Authorized Official
Title or Position : OWNER/ DO
Name : MATTHEW ROBIN
Credential : DO
Telephone Number : 312-796-7121
Provider Enumeration Date : 11/17/2017
Last Update Date : 08/31/2019

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Directions to “BRIGHTLAND HEALTH LLC ” Practice Location

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