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BRIGHTLIFE REGENERATIVE MEDICAL CLINIC LOMBARD SC NPI 1306465786


NPI Information

NPI: 1306465786
Provider Name: BRIGHTLIFE REGENERATIVE MEDICAL CLINIC LOMBARD SC
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
442 E ROOSEVELT RD
LOMBARD, IL
ZIP 60148
Phone: (630) 261-0001
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BRIGHTLIFE REGENERATIVE MEDICAL CLINIC LOMBARD SC is a general practice in Lombard, IL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee BRIGHTLIFE REGENERATIVE MEDICAL CLINIC LOMBARD SC NPI is 1306465786. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

442 E ROOSEVELT RD
LOMBARD, IL
ZIP 60148-630
Phone: (630) 261-0001

The provider's authorized official is Steven Burlison .
The authorized official title is President and has the following contact phone number (630) 261-0001.

The enumeration date for this NPI number is 4/15/2020 and was last updated on 4/17/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208D00000XGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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