Dr Jacqueline Bardwell Ltd

LBN: Dr Jacqueline Bardwell Ltd
Dr Jacqueline Bardwell Ltd is an health care organization with primary practice located at 4403 W Lawrence Ave Suite 200, Chicago IL 60630-2513. The organization recently has only one registered license in Ambulatory Health Care Facilities / Adult Mental Health, which is considered as the primary health care specialty. Dr Jacqueline Bardwell Ltd can be contacted via phone (773) 736-1555, or through Bardwell, Jacqueline via phone (773) 736-1555.

Contact Information

Primary practice address
4403 W Lawrence Ave Suite 200 Chicago IL 60630-2513
Phone: (773) 736-1555
Fax: (773) 736-1552
Website:
Map and Directions
Authorized official contact:
Name: Bardwell, Jacqueline Doctor of Medicine (MD)
Phone: (773) 736-1555

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X

Profile Details

NPI number 1245483940
LBN Legal business name Dr Jacqueline Bardwell Ltd
DBA Doing business as
Authorized official Bardwell, Jacqueline Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 28th, 2008
Last updated Oct 28th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245483940 NPPES
Illinois MEDICAID 036071838

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