Individual
DR. JEREMY TODD BIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
111 DEAN ST, WOODSTOCK, IL 60098-3220
(815) 344-5061
(815) 344-5072
Mailing address
111 DEAN ST, WOODSTOCK, IL 60098-3220
(815) 344-5061
(815) 344-5072
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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