Provider Demographics
NPI:1093969123
Name:ARTRIP, BRIDGET FAYE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:BRIDGET
Middle Name:FAYE
Last Name:ARTRIP
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BRIDGET
Other - Middle Name:FAYE
Other - Last Name:WENBAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1850 GATEWAY DR STE 203
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-3192
Mailing Address - Country:US
Mailing Address - Phone:815-766-3942
Mailing Address - Fax:815-758-5482
Practice Address - Street 1:1850 GATEWAY DR STE 203
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-3192
Practice Address - Country:US
Practice Address - Phone:815-766-3942
Practice Address - Fax:815-758-5482
Is Sole Proprietor?:No
Enumeration Date:2008-11-17
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085003367363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant