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BRAIN HEALTH RESTORATION ILLINOIS LLC NPI 1700653961


NPI Information

NPI: 1700653961
Provider Name: BRAIN HEALTH RESTORATION ILLINOIS LLC
Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 29D2287790

Address:
1111 N PLAZA DR STE 101
SCHAUMBURG, IL
ZIP 60173
Phone: (775) 507-7024
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BRAIN HEALTH RESTORATION ILLINOIS LLC is a general practice in Schaumburg, 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 BRAIN HEALTH RESTORATION ILLINOIS LLC NPI is 1700653961. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1111 N PLAZA DR STE 101
SCHAUMBURG, IL
ZIP 60173-916
Phone: (775) 507-7024

The provider's authorized official is Walter Marting .
The authorized official title is Owner and has the following contact phone number (775) 742-4911.

The CLIA number assigned to this NPI record is 29D2287790 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/7/2023 and was last updated on 12/7/2023.


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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