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Individual

BRIDGET ROSE DAVIDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
5140 N CALIFORNIA AVE, STE 635, CHICAGO, IL 60625-3645
(773) 989-6200
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
209009174
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
041384723
IL
01
406120066
PTAN
Enumeration date
04/06/2012
Last updated
07/10/2024
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