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Organization
DOREENA M MCBRIDE MD PC
Active
Organization
DOREENA M MCBRIDE MD PC
Active
Other names
PEDICLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DOREENA MCBRIDE MD (PRESIDENT)
(815) 933-5700
Entity
Organization
Contact information
Practice address
461 BROWN BLVD, BOURBONNAIS, IL 60914-2322
(815) 933-5700
(815) 933-8011
Mailing address
461 BROWN BLVD, BOURBONNAIS, IL 60914-2322
(815) 933-5700
(815) 933-8011
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14D0918525
CLIA
IL
01
—
4604555
BCBS
IL
Enumeration date
07/06/2006
Last updated
04/30/2015
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