Brightlife Regenerative Medical Clinic of Bolingbrook

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

BRIGHTLIFE REGENERATIVE MEDICAL CLINIC OF BOLINGBROOK

Practice address

231 N Bolingbrook Dr
Bolingbrook, IL 60440-1960

Phone

(630) 759-8989

NPI assigned

Jan 29, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Steven Burlison

Title

Owner

Phone

(630) 759-8989

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611878400000",
    "number": "1285225508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 N BOLINGBROOK DR",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401960",
            "telephone_number": "630-759-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 N BOLINGBROOK DR",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401960",
            "telephone_number": "630-759-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTLIFE REGENERATIVE MEDICAL CLINIC OF BOLINGBROOK",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-29",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A",
        "authorized_official_last_name": "BURLISON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-759-8989",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Catherine Brady, LCSW
• Janet Brancato
• Matt Branchaw
• Emilie Brazinski, LPC
• Bridgewell LLC
• Karla Rhea Brooks
• Alana Brown
• Kalyna Yvette Brumfield
• Deborah Brunick, LCSW
• Bryan J Phillips MD SC

• General Practice Physician in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.