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Individual

MS. BRIDGET FAITH CANTRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN, ACNP

Contact information

Practice address
1700 LUTHER LN STE 1170, PARK RIDGE, IL 60068-1270
(844) 376-3876
(847) 723-2041
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.327232
IL
363L00000X
Nurse Practitioner
Primary
209009689
IL
363LA2100X
Acute Care Nurse Practitioner
209.009689
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
206147
MEDICARE PTAN (GROUP)
IL
01
206147141
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
08/30/2012
Last updated
06/13/2022
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