MEDICARE: BRIGID ONEILL

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
1	133V00000X	Registered Dietitian	164.011055	IL

General Provider Information

NPI Number	:	1487477527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIGID ONEILL

Provider Business Mailing Address
First Line	:	2548 W MEDILL AVE APT 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-3131
Country	:	US
Telephone Number	:	773-633-0262
Fax Number	:

Provider Business Practice Location Address
First Line	:	2548 W MEDILL AVE APT 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-3131
Country	:	US
Telephone Number	:	773-633-0262
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2024
Last Update Date	:	07/01/2025

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Directions to “ BRIGID ONEILL ” Practice Location

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