Provider Demographics
NPI:1184137978
Name:MCBRIDE, LINDA (MS, RN)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:MS, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5250 OLD ORCHARD RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-4462
Mailing Address - Country:US
Mailing Address - Phone:847-423-6477
Mailing Address - Fax:
Practice Address - Street 1:3612 N RICHMOND ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-4614
Practice Address - Country:US
Practice Address - Phone:773-597-5045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-196256163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL041-196256OtherSTATE OF ILLINOIS DEPT OF REGULATION - REGISTERED NURSE