Provider Demographics
NPI:1023441854
Name:BATES, BRIDGET MAUREEN (DPT)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:MAUREEN
Last Name:BATES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BRIDGET
Other - Middle Name:MAUREEN
Other - Last Name:WILKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:625 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-8813
Mailing Address - Country:US
Mailing Address - Phone:630-575-6250
Mailing Address - Fax:630-575-7450
Practice Address - Street 1:19801 GOVERNORS HWY STE 100
Practice Address - Street 2:
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-4363
Practice Address - Country:US
Practice Address - Phone:708-647-1500
Practice Address - Fax:708-647-1800
Is Sole Proprietor?:No
Enumeration Date:2013-08-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070019993225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist