Provider Demographics
NPI:1164964649
Name:FLANAGAN, BRIDGET (APRN)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6702 N NORTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-1320
Mailing Address - Country:US
Mailing Address - Phone:773-775-6105
Mailing Address - Fax:
Practice Address - Street 1:6702 N NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-1320
Practice Address - Country:US
Practice Address - Phone:773-775-6105
Practice Address - Fax:773-631-7012
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209015093363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care