Brightlife Regenerative Medical Clinic SC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

BRIGHTLIFE REGENERATIVE MEDICAL CLINIC SC

Practice address

1580 S Milwaukee Ave Ste 102
Libertyville, IL 60048-3770

Phone

(847) 680-9500

NPI assigned

Oct 15, 2018

Last updated

Nov 27, 2019By 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

Dr. Steven C Burlison, CHIROPRACTOR (D.C.)NPI 1962603860

Title

President

Phone

(847) 680-9500

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Steven Charles Burlison, D.C.

  • Chiropractor
  • Battle Creek, MI
  • NPI 1962603860
  Authorized official Same address or phone
• Omar A. Bleibel, DC

  • Chiropractor
  • Chicago, IL
  • NPI 1073156238
  NPD (past)
• David B. Rosania, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Hinsdale, IL
  • NPI 1346281888
  NPD (past)

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574812800000",
    "number": "1548736796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 S MILWAUKEE AVE STE 102",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483770",
            "telephone_number": "847-680-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 S MILWAUKEE AVE STE 102",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483770",
            "telephone_number": "847-680-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTLIFE REGENERATIVE MEDICAL CLINIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-15",
        "last_updated": "2019-11-27",
        "status": "A",
        "authorized_official_last_name": "BURLISON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-680-9500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "CHIROPRACTOR (D.C.)"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Aaron Breit, M.D.
• Melissa Brennan, ED.S, LCPC
• Patricia Bress, SLP
• Brian P Danielewicz DDS LTD
• Anastasia Brierton, DO
• John Phillippe Broadnax, M.D.
• Broadreach Counseling LLC
• Richard N. Brochu, DDS
• Christianna Broton, SLP
• Browdy Home Care, Inc. (Visiting Angels Libertyville)

• Clinic/Center in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; 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.