Bridgewell LLC

NPI #1972296382 in Bolingbrook, Illinois

Provider Information

NPI Number: 1972296382
Entity Type: Organization
Organization Name: Bridgewell LLC
Primary Specialty: Nurse Practitioner - Primary Care
Enumeration Date: May 31, 2023
Last Updated: Sep 1, 2023

Practice Location

Address: 402 W BOUGHTON RD STE A
City: Bolingbrook
State: Illinois
ZIP Code: 60440-1998
Phone: (312) 451-6148

Authorized Official

Name: ISOKEN OGBOMO, FNP
Title: NURSE PRACTITIONER
Phone: (312) 451-6418

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Primary Care — Primary Care	261QP2300X
Clinic/Center - Community Health — Community Health	261QC1500X
Nurse Practitioner - Primary Care — Primary Care	363LP2300X	Primary

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