Individual
DR. JEREMY TODD BIDWELL
Active
Individual
DR. JEREMY TODD BIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
071.007831
IL
103TP0016X
Prescribing (Medical) Psychologist
Primary
074.000011
IL
Other
Enumeration date
02/01/2010
Last updated
12/15/2021
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