Organization
BRIDGE TO CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESIREE CUNNINGHAM NP (NURSE PRACITITIONER)
(773) 616-5330
Entity
Organization
Contact information
Practice address
3300 CRAIN ST, SKOKIE, IL 60076-2408
(773) 616-5330
Mailing address
3300 CRAIN ST, SKOKIE, IL 60076-2408
(773) 616-5330
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Enumeration date
02/15/2021
Last updated
11/02/2021
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