Bridgemark Medical Supply LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

BRIDGEMARK MEDICAL SUPPLY LLC

Practice address

1140 Lake St
Suite 410
Oak Park, IL 60301-1049

Phone

(312) 994-2306

NPI assigned

Feb 20, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stephen P Miller

Title

MBR

Phone

(312) 994-2306

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1134264286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 LAKE ST",
            "address_2": "SUITE 410",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011049",
            "telephone_number": "312-994-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 LAKE ST",
            "address_2": "SUITE 410",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011049",
            "telephone_number": "312-994-2306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEMARK MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MBR",
        "authorized_official_telephone_number": "312-994-2306"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karina Breezer
• Sheila Maureen Brennan-Johnson
• Sherri Ann Brennan, R.D.
• Brian a. King
• Jasmine Haley Brice
• Colin A. Brietzke, PSY. D.
• Justine Britten, RDN
• Esther S. Brodsky, LCSW
• Brittney Brooks, MA
• Deasia I Brooks

• Customized Equipment (DME) in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Customized Equipment (DME) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.