Healthcare Provider Details

I. General information

NPI: 1386688109
Provider Name (Legal Business Name): WENDY JOY BRICKMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 CHILDRENS PLAZA MC #54 CHILDRENS MEMORIAL HOSPITAL
CHICAGO IL
60614
US

IV. Provider business mailing address

2300 CHILDRENS PLAZA MC #54 CHILDRENS MEMORIAL HOSPITAL
CHICAGO IL
60614
US

V. Phone/Fax

Practice location:
  • Phone: 773-880-4440
  • Fax: 773-880-4063
Mailing address:
  • Phone: 773-880-4440
  • Fax: 773-880-4063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: