Bradley, Douglas

Bradley, Douglas is an individual health care provider with primary practice located at 313 N Weber Rd , Bolingbrook IL 60490-1569. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Bradley, Douglas can be contacted via phone (630) 771-0850.

Contact Information

Primary practice address
313 N Weber Rd Bolingbrook IL 60490-1569
Phone: (630) 771-0850
Fax: (630) 771-0852
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 070009229 Illinois
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 05007954A Indiana

Profile Details

NPI number 1033303862
LBN Legal business name Bradley, Douglas
Credentials PT, CSCS
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 5th, 2007
Last updated Jan 20th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033303862 NPPES
Other 01622333 BLUE CROSS BLUE SHIELD ID
Other 7454077 BLUE CROSS BLUE SHIELD ID

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