DAVID KUSHNER DO PC NPI 1760020663

NPI Information

NPI: 1760020663
Provider Name: DAVID KUSHNER DO PC
Classification: Clinic/Center - 261QM0801X
Specialization: Mental Health (Including Community Mental Health Center)
Entity Type: Organization
Doing Business As: BRIGHTSIDE CLINIC
CLIA Number: 14D2285341
Address: 400 LAKE ST STE 302A
ROSELLE, IL
ZIP 60172
Phone: (224) 205-7863

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NPI Details

DAVID KUSHNER DO PC is a mental health (including community mental health center) clinic center in Roselle, IL. DAVID KUSHNER DO PC NPI is 1760020663. The provider is registered as an organization entity type.
The provider Is Doing Business As Brightside Clinic.

The provider's business location address is:

400 LAKE ST STE 302A
ROSELLE, IL
ZIP 60172-523
Phone: (224) 205-7863

The provider's authorized official is Philip Atteberry .
The authorized official title is Ceo and has the following contact phone number (224) 205-7868.

The CLIA number assigned to this NPI record is 14D2285341 - other - outpatient treatment prog with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/11/2019 and was last updated on 2/22/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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