B Bridge Back LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

B BRIDGE BACK LLC

Doing business as

B Bridge back LLC

Practice address

1655 N Arlington Heights Rd Ste 305
Arlington Heights, IL 60004-3982

Phone

(844) 427-6739

NPI assigned

Jul 6, 2020

Last updated

Nov 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dimitry Likterev, DC

Title

Co-Owner

Phone

(844) 877-2440

Specialties & licenses 1

Addresses

Other names 1

• B Bridge back LLC Doing business as

Locations

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1356969406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 MCHENRY RD",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600892428",
            "telephone_number": "844-877-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 N ARLINGTON HEIGHTS RD STE 305",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600043982",
            "telephone_number": "844-427-6739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B BRIDGE BACK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-06",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "LIKTEREV",
        "authorized_official_first_name": "DIMITRY",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "844-877-2440",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "B Bridge back LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "B Bridge back LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Physician in Arlington Heights, IL
• Providers in Arlington Heights, 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 Nov 18, 2024; 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.