Individual
MRS. BRIDGET EILEEN WIACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1800 N MAIN ST FL 2, WHEATON, IL 60187-3112
(630) 315-6123
(630) 682-3727
Mailing address
1800 N MAIN ST, WHEATON, IL 60187-3112
(630) 614-4960
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209.015795
IL
Other
Enumeration date
10/18/2017
Last updated
05/03/2018
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