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Contact Information

BRIDGEWELL LLC
402 W BOUGHTON RD STE A
BOLINGBROOK, IL60440-1998
 Phone: 312-451-6148
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Primary Care

363LP2300X 50 Nurse Practitioner
 

Community Health

261QC1500X
 

Primary Care

261QP2300X
Indicates primary specialty

NPI Profile & details for BRIDGEWELL LLC

NPI Number 1972296382
LBN Legal business name BRIDGEWELL LLC
Authorized official ISOKEN OGBOMO - (NURSE PRACTITIONER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/31/2023
Last updated 09/01/2023 - About 3 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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