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NPI Code Detail

MEDICARE: BRIDGET WESLEY LCSW

MEDICARE: BRIDGET WESLEY LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerIL

General Provider Information

NPI Number : 1003031196
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIDGET WESLEY LCSW
Provider Business Mailing Address
First Line : 1156 W SHURE DR STE 180
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-7803
Country : US
Telephone Number : 847-392-8820
Fax Number :
Provider Business Practice Location Address
First Line : 1156 W SHURE DR STE 180
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-7803
Country : US
Telephone Number : 847-392-8820
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2007
Last Update Date : 07/08/2007

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Directions to “ BRIDGET WESLEY LCSW” Practice Location

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