Healthcare Provider Details

I. General information

NPI: 1912431024
Provider Name (Legal Business Name): BRIDGET SCHRANK L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2017
Last Update Date: 11/02/2022
Certification Date: 11/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

666 DUNDEE RD STE 1201
NORTHBROOK IL
60062-2736
US

IV. Provider business mailing address

301 CHIPILI DR
NORTHBROOK IL
60062-4806
US

V. Phone/Fax

Practice location:
  • Phone: 773-245-3089
  • Fax:
Mailing address:
  • Phone: 773-245-3089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number198001242
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: