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:
Health care specialties
Specialty | Code | License # | 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 8 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1033303862 | NPPES |
Other | 01622333 | BLUE CROSS BLUE SHIELD ID | |
Other | 7454077 | BLUE CROSS BLUE SHIELD ID |
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