Individual
BRIDGET WILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(312) 227-4000
Mailing address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(847) 570-2833
(247) 733-5768
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036.133836
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2011
Last updated
03/31/2021
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