NPIMap

Organization Active NPI

Bridgeway Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Loves Park, IL
National Provider Identifier
1235626326
Registry record updated Apr 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
BRIDGEWAY INC.
Practice address
7200 Clinton Rd
Loves Park, IL 61111-3806
Phone
(815) 962-8333
NPI assigned
Apr 16, 2018
Organization subpart
Yes
Parent organization
BRIDGEWAY INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 16, 2018

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

Authorized official

Name
William Nelson
Title
Ceo
Phone
(309) 344-2323

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X IL Primary

Addresses

Primary practice location

7200 Clinton Rd
Loves Park, IL 61111-3806

Mailing address

7200 Clinton Rd
Loves Park, IL 61111-3806
Phone (815) 962-8333

Other identifiers 1

IdentifierTypeStateIssuer
655360OtherILUPIN

Other names 1

  • Love's Park Other name

National Provider Directory

National Provider Directory
Tax ID family
Julio R Lozano MD15 organizations share this tax ID, including this one
Part of
Julio R Lozano MD

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523836800000",
    "number": "1235626326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 CLINTON RD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611113806",
            "telephone_number": "815-962-8333",
            "fax_number": "815-964-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 CLINTON RD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611113806",
            "telephone_number": "815-962-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEWAY INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRIDGEWAY INC.",
        "enumeration_date": "2018-04-16",
        "last_updated": "2018-04-16",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "309-344-2323"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "655360",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Love's Park",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Love's Park",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Loves Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; 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.