Provider Demographics
NPI:1760236228
Name:MCBRIDE, ABIGAIL
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ABBIE
Other - Middle Name:
Other - Last Name:MCBRIDE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:450 W BRIAR PL APT 8M
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-4743
Mailing Address - Country:US
Mailing Address - Phone:630-640-9160
Mailing Address - Fax:
Practice Address - Street 1:450 W BRIAR PL APT 8M
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4743
Practice Address - Country:US
Practice Address - Phone:630-640-9160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health