1215751177 NPI number — MR. DEVIN SCOTT BRATCHER DNP, FNP-BC, APRN

Table of content: DR. JOHN MICHAEL SEGNINI D.D.S. (NPI 1679533244)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215751177 NPI number — MR. DEVIN SCOTT BRATCHER DNP, FNP-BC, APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BRATCHER
Provider First Name:
DEVIN
Provider Middle Name:
SCOTT
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
DNP, FNP-BC, APRN
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215751177
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2650 RIDGE AVE.
Provider Second Line Business Mailing Address:
SUITE 1223
Provider Business Mailing Address City Name:
EVANSTON
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60201-1718
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-570-2040
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5999 NEW WILKE RD STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROLLING MEADOWS
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60008-4502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-618-0800
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/07/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  209.030827 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: 209030827 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)