Provider Demographics
NPI:1942237391
Name:ALDRIDGE, DELIA (MD)
Entity Type:Individual
Prefix:
First Name:DELIA
Middle Name:
Last Name:ALDRIDGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DELIA
Other - Middle Name:
Other - Last Name:PATROI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4201 LAKE COOK RD
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-1060
Mailing Address - Country:US
Mailing Address - Phone:847-807-7537
Mailing Address - Fax:847-843-7393
Practice Address - Street 1:4201 LAKE COOK RD
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-1060
Practice Address - Country:US
Practice Address - Phone:847-807-7537
Practice Address - Fax:847-843-7393
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-1031522084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL92740Medicare ID - Type UnspecifiedMEDICARE #
ILH31386Medicare UPIN