Provider Demographics
NPI:1790538957
Name:BRIDICH, ELAINA
Entity Type:Individual
Prefix:
First Name:ELAINA
Middle Name:
Last Name:BRIDICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 E KATHLEEN DR
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-2737
Mailing Address - Country:US
Mailing Address - Phone:847-257-3545
Mailing Address - Fax:
Practice Address - Street 1:1430 N ARLINGTON HEIGHTS RD STE 201
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-4825
Practice Address - Country:US
Practice Address - Phone:847-707-6744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist