Bridgeway Inc | |
2323 Windish Dr Galesburg IL 61401-9780 | |
(309) 344-4200 | |
(309) 344-4281 |
Full Name | Bridgeway Inc |
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Speciality | Clinic/Center |
Location | 2323 Windish Dr, Galesburg, Illinois |
Authorized Official Name and Position | Bill Nelson (CEO) |
Authorized Official Contact | 3093444200 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Bridgeway Inc 2323 Windish Dr Galesburg IL 61401-9780 Ph: (309) 344-4200 | Bridgeway Inc 2323 Windish Dr Galesburg IL 61401-9780 Ph: (309) 344-4200 |
NPI Number | 1851315535 |
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Provider Enumeration Date | 07/27/2006 |
Last Update Date | 08/19/2019 |
Medicare PECOS PAC ID | 4284627530 |
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Medicare Enrollment ID | O20050126000609 |
Identifier | Type | State | Issuer |
---|---|---|---|
1851315535 | NPI | - | NPPES |
001180005 | Other | IL | CERTIFIC/LICENSE |
Provider Name | Lourdes J Delgado Serrano |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1508834839 PECOS PAC ID: 2365522935 Enrollment ID: I20080108000902 |
Provider Name | Maria D Linden |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1316137490 PECOS PAC ID: 6002967536 Enrollment ID: I20180921002442 |
Provider Name | Mary N Mcelwain |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1851717011 PECOS PAC ID: 4981040425 Enrollment ID: I20240307000533 |
Provider Name | Melissa Simmons |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1740607522 PECOS PAC ID: 2769828235 Enrollment ID: I20240307001265 |
Provider Name | Rebekah Dees-mcmahon |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1073904348 PECOS PAC ID: 5991141467 Enrollment ID: I20240307001445 |
Provider Name | Lindsay K Garmon |
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Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1205608577 PECOS PAC ID: 5799121919 Enrollment ID: I20240311002530 |
Provider Name | Stacy L Brown |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1265976385 PECOS PAC ID: 8224474259 Enrollment ID: I20240312002950 |
Provider Name | Amy S Taylor |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1467937391 PECOS PAC ID: 1557709045 Enrollment ID: I20240403000785 |
Provider Name | Mark Brothe |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1447851373 PECOS PAC ID: 1254779317 Enrollment ID: I20240409001662 |
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