Provider Demographics
NPI:1881190577
Name:ZIGANTE, BRIDGET MACKENZIE
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:MACKENZIE
Last Name:ZIGANTE
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 1:10800 PARTRIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IL
Mailing Address - Zip Code:60071-9229
Mailing Address - Country:US
Mailing Address - Phone:815-219-9202
Mailing Address - Fax:
Practice Address - Street 1:10800 PARTRIDGE TRL
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IL
Practice Address - Zip Code:60071-9229
Practice Address - Country:US
Practice Address - Phone:815-219-9202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer