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NPI Code Detail

MEDICARE: BRIDGETTE LOVE

MEDICARE: BRIDGETTE LOVE
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
12865M2000XMilitary General Acute Care Hospital041319239IL

General Provider Information

NPI Number : 1629402920
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIDGETTE LOVE
Provider Business Mailing Address
First Line : 4045 S LAKE PARK AVE # 302
Second Line :
City : CHICAGO
State : IL
Zip : 60653-2578
Country : US
Telephone Number : 773-924-5377
Fax Number :
Provider Business Practice Location Address
First Line : 4045 S LAKE PARK AVE # 302
Second Line :
City : CHICAGO
State : IL
Zip : 60653-2578
Country : US
Telephone Number : 773-924-5377
Fax Number :
Authorized Official
Title or Position : REGISTERED NURSE/ICU
Name : BRIDGETTE LOVE
Credential : RN
Telephone Number : 773-924-5377
Provider Enumeration Date : 08/22/2013
Last Update Date : 08/22/2013

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Directions to “BRIDGETTE LOVE ” Practice Location

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