Provider Demographics
NPI:1912542226
Name:BRAVI HEALTH LIMITED
Entity Type:Organization
Organization Name:BRAVI HEALTH LIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAVI
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:773-407-2050
Mailing Address - Street 1:5208 N WINTHROP AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-2358
Mailing Address - Country:US
Mailing Address - Phone:773-407-2050
Mailing Address - Fax:
Practice Address - Street 1:645 N MICHIGAN AVE STE 543
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2881
Practice Address - Country:US
Practice Address - Phone:312-521-0064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-11
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation