Provider Demographics
NPI:1952815656
Name:BRIGHTLAND HEALTH LLC
Entity Type:Organization
Organization Name:BRIGHTLAND HEALTH LLC
Other - Org Name:BRIGHTLAND HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/ DO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:312-796-7121
Mailing Address - Street 1:800 W DIVERSEY PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1412
Mailing Address - Country:US
Mailing Address - Phone:312-796-7121
Mailing Address - Fax:888-523-4767
Practice Address - Street 1:800 W DIVERSEY PKWY STE 200
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1412
Practice Address - Country:US
Practice Address - Phone:312-796-7121
Practice Address - Fax:888-523-4767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-17
Last Update Date:2019-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty