Bridget Wild, | |
2650 Ridge Ave, Evanston, IL 60201-1700 | |
(312) 227-4000 | |
Not Available |
Full Name | Bridget Wild |
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Gender | Female |
Speciality | Pediatrics |
Location | 2650 Ridge Ave, Evanston, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1821387150 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 036.133836 (Illinois) | Primary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
Entity Name | Swedish Covenant Management Services Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760432348 PECOS PAC ID: 4486556016 Enrollment ID: O20040123000850 |
Entity Name | Northshore University Healthsystem Faculty Practice Associates |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1497701882 PECOS PAC ID: 2163334699 Enrollment ID: O20040524000118 |
Mailing Address | Practice Location Address |
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Bridget Wild, 2650 Ridge Ave, Evanston, IL 60201-1700 Ph: (847) 570-2833 | Bridget Wild, 2650 Ridge Ave, Evanston, IL 60201-1700 Ph: (312) 227-4000 |
Dr. Rosita Stephen Pildes, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1319 Ridge Ave, Evanston, IL 60201 Phone: 847-491-9742 Fax: 847-491-9740 | |
Dr. Sadie Anne Laponsie, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2650 Ridge Ave, Evanston, IL 60201 Phone: 847-570-2000 | |
Susan Amy Roth, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1000 Central St, Suite 765, Evanston, IL 60201 Phone: 847-570-1507 Fax: 847-570-1577 | |
Ana Claudia Taddei, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2650 Ridge Ave, Evanston, IL 60201 Phone: 847-570-2530 Fax: 847-570-0231 | |
Julie Shields Holland, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1000 Central St, Suite 765, Evanston, IL 60201 Phone: 847-570-1507 Fax: 847-570-1577 | |
Dr. Najah Senno Musacchio, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1600 Dodge Ave Rm H-101, Evanston, IL 60201 Phone: 847-424-7265 Fax: 847-492-5809 | |
Sharon M Robinson, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1000 Central St, Suite 765, Evanston, IL 60201 Phone: 847-570-1507 Fax: 847-570-1577 |