Organization Active NPI

Brightland Health LLC

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1952815656
Registry record updated Aug 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
BRIGHTLAND HEALTH LLC
Practice address
800 W Diversey Pkwy Ste 200
Chicago, IL 60614-1412
Phone
(312) 796-7121
Fax
(888) 523-4767
NPI assigned
Nov 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2019

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

Authorized official

Name
Matthew Robin, DONPI 1447499470
Title
Owner/ DO
Phone
(312) 796-7121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

800 W Diversey Pkwy Ste 200
Chicago, IL 60614-1412

Mailing address

800 W Diversey Pkwy Ste 200
Chicago, IL 60614-1412
Phone (312) 796-7121

Other names 1

  • Brightland Health Other name

National Provider Directory

National Provider Directory

Locations

800 W Diversey Pkwy
Ste 200
Chicago, IL 60614
Phone (312) 796-7121

561 W Diversey Pkwy
Ste 217
Chicago, IL 60614
Phone (773) 906-4546

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567209600000",
    "number": "1952815656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W DIVERSEY PKWY STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141412",
            "telephone_number": "312-796-7121",
            "fax_number": "888-523-4767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W DIVERSEY PKWY STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141412",
            "telephone_number": "312-796-7121",
            "fax_number": "888-523-4767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTLAND HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-17",
        "last_updated": "2019-08-31",
        "status": "A",
        "authorized_official_last_name": "ROBIN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER/ DO",
        "authorized_official_telephone_number": "312-796-7121",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brightland Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.