Provider Demographics
NPI:1679859888
Name:BAHDE, ERIN MARIE (ATC)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:MARIE
Last Name:BAHDE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:MARIE
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:1137 N EOLA RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-7096
Mailing Address - Country:US
Mailing Address - Phone:630-928-3400
Mailing Address - Fax:
Practice Address - Street 1:579 N OAKHURST DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502-9080
Practice Address - Country:US
Practice Address - Phone:630-928-3400
Practice Address - Fax:630-898-1874
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL096.0029802255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer