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Individual

MRS. LINDA J BIDDISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AP RN, BC

Contact information

Practice address
2524 FARRAGUT DR # C, SPRINGFIELD, IL 62704-8400
(217) 698-3505
(217) 698-3502
Mailing address
9138 N TIMBER LN, PEORIA, IL 61615-1449
(309) 691-7879
(217) 872-1704

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0005832068
BC BS GROUP
IL
01
1326069014
NPI INDIVIDUAL
IL
01
1528084266
GROUP NPI
IL
01
DE5770
RR MEDICARE GROUP
IL
01
P00301784
INDIVIDUAL RR MEDICARE NO
IL
Enumeration date
07/21/2006
Last updated
07/09/2007
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