Individual
MS. BRIDGET STEPHENS LECLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2320 E 93RD ST, CHICAGO, IL 60617-3909
(773) 967-5430
(773) 967-4205
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-005410
IL
363A00000X
Physician Assistant
99047912A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201141630
OPR
IN
01
—
P01214730
RR MEDICARE PTAN
IN
Enumeration date
07/21/2011
Last updated
03/26/2026
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