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DR. TIMOTHY MICHAEL BRADLEY MD NPI 1568682508


NPI Information

NPI: 1568682508
Provider Name: DR. TIMOTHY MICHAEL BRADLEY, MD
Classification: Surgery - 2086S0122X
Entity Type: Individual

Specialization: Plastic and Reconstructive Surgery

PECOS Registration: Yes

Address:
3310 W MAIN ST
SUITE 200
ST CHARLES, IL
ZIP 60175
Phone: (630) 897-6044
Get Directions

DR. Timothy Michael Bradley, MD is a plastic and reconstructive surgery surgery in St Charles, IL. The provider is a surgeon who specializes in plastic and reconstructive surgery. DR. Timothy Michael Bradley, MD NPI is 1568682508. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3310 W MAIN ST
SUITE 200
ST CHARLES, IL
ZIP 60175-000
Phone: (630) 897-6044
Fax: (630) 659-3502

The NPI 1568682508 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 5/1/2007 and was last updated on 7/16/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12086S0105XSurgerySurgery of the Hand036-082971ILLINOISNo
22086S0122XSurgeryPlastic and Reconstructive Surgery036-082971ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10727500002MEDICARE NSCILLINOIS
2036-082971MEDICAIDILLINOIS
3390361MEDICARE PINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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