Organization
BRIDGEWAY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BILL NELSON (CEO)
(309) 344-4337
Entity
Organization
Contact information
Practice address
301 INDUSTRIAL PARK RD, MONMOUTH, IL 61462-9794
(309) 734-9461
(309) 734-3909
Mailing address
301 INDUSTRIAL PARK RD, MONMOUTH, IL 61462-9794
(309) 734-9461
(309) 734-3909
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
IL
2084P0804X
Child & Adolescent Psychiatry Physician
—
IL
251S00000X
Community/Behavioral Health Agency
003
IL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/11/2007
Last updated
07/21/2022
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