DR. ERIC BRADLEY FULLER (NPI# 1194036210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194036210 |
| Entity Type | Individual |
| Full Name | DR. ERIC BRADLEY FULLER |
| Credential | M.D. |
| Practice Address |
225 E Chicago Ave Box 69 Chicago IL 60611-2991 |
| Practice Telephone | 3122276190 |
| Mailing Telephone | 3122276190 |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2016-09-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 125-058032 | IL | Allopathic & Osteopathic Physicians |
| Y | 207XP3100X |
Orthopaedic Surgery Specialization: Pediatric Orthopaedic Surgery |
036.132558 | IL | Allopathic & Osteopathic Physicians |
| N | 207XP3100X |
Orthopaedic Surgery Specialization: Pediatric Orthopaedic Surgery |
137416 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144865957 | Eric Alan Fuller | Audiologist-Hearing Aid Fitter | 700 East 2nd Street, Suite C, Rome, GA 30161 | 2019-11-15 |
| 1346234457 | Eric Arthur Fuller | Podiatrist | 1178 San Pablo Ave, Suite A, Berkeley, CA 94706-2245 | 2005-09-02 |
| 1982231619 | Eric Fuller | Behavior Technician | 10320 W Mcdowell Rd Ste Avondale, Avondale, AZ 85392-4863 | 2020-03-24 |
| Street Address |
225 E CHICAGO AVE BOX 69 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60611-2991 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790779734 | Martha Cotsen Saker | Radiology | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2005-09-06 |
| 1356942239 | Sara Mancuso | Nurse Practitioner | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2020-11-05 |
| 1912514423 | Emily May Wilson | Audiologist | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2020-09-29 |
| 1780291617 | Loretta Lavigne | Social Worker | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2020-09-24 |
| 1275149312 | Abigail Hadley | Registered Nurse | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2020-09-22 |
| 1326653866 | Lauren Spradling | Dietitian, Registered | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2020-09-11 |
| 1629682232 | Agnes Kim | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2020-09-01 | |
| 1861006405 | Samantha A Grooss | Dietitian, Registered | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2020-09-01 |
| 1255945838 | Patrice H. Swiontek | Dietitian, Registered | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2020-09-01 |
| 1205440088 | Lisa Sharda | Dietitian, Registered | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2020-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092835 | Lauren Less | Social Worker | 111 East Pearson St, Chicago, IL 60611 | 2020-10-29 |
| 1134735962 | Kalvin Cheuk Hang Lung | Student in an Organized Health Care Education/Training Program | 675 N St Clair St 17th Floor, Chicago, IL 60611 | 2020-09-17 |
| 1487267845 | Ashley Marie Sablich | Student in an Organized Health Care Education/Training Program | 250 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2020-08-26 |
| 1245854033 | Danielle Humphrey | Student in an Organized Health Care Education/Training Program | Pa Program, Suite 1-200, 240 East Huron Street, Chicago, IL 60611 | 2020-06-08 |
| 1801418074 | Sana Healing Collective | Clinic/Center | 405 N. Wabash Street, Chicago, IL 60611 | 2020-05-11 |
| 1194359489 | Insight:eating Disorders, Weight Management & Psychological Centers | Psychiatric Hospital | 1 E. Erie Street, 4th Floor, Chicago, IL 60611 | 2020-02-26 |
| 1902439193 | Iwona Boska | Nurse Practitioner | 676 N St.clair Street, Suite 2140, Chicago, IL 60611 | 2020-02-17 |
| 1922643576 | Sarah Elizabeth Schwartzer | Audiologist | Chicago Dizziness and Hearing, 645 North Michigan Avenue, Suite 410, Chicago, IL 60611 | 2019-11-07 |
| 1023668852 | Anne Marguerite Davidson | Student in an Organized Health Care Education/Training Program | Mcgraw Medical Center, 240 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2019-09-13 |
| 1871141085 | Coast Management | Durable Medical Equipment & Medical Supplies | 40 E. Chicago Ave, Suite 149, Chicago, IL 60611 | 2019-08-30 |
| Find all providers in zip 60611 | ||||
| Taxonomy Code | 207XP3100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Pediatric Orthopaedic Surgery |
| An orthopedic surgeon who has additional training and experience in diagnosing, treating and managing musculoskeletal problems in infants, children and adolescents. These may include limb and spine deformities (such as club foot, scoliosis); gait abnormalities (limping); bone and joint infections; broken bones. |
| Notes: Source: American Academy of Pediatrics, www.aap.org [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871138933 | Brigid Smigiel | Orthopaedic Surgery | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2019-11-13 |
| 1871930693 | Shriners Hospitals for Children | Orthopaedic Surgery | 2211 N Oak Park Ave, Chicago, IL 60707-3351 | 2013-06-03 |
| 1679781355 | Orthopaedic and Rehabilitation Centers Sc | Orthopaedic Surgery | 5616 N Western Ave, Chicago, IL 60659-5113 | 2007-05-18 |
| 1427260959 | Joseph Aloysius Janicki | Orthopaedic Surgery | 225 E Chicago Ave, Box #69, Chicago, IL 60611-2991 | 2007-05-04 |
| 1487704052 | Michelle Lee Sagan | Orthopaedic Surgery | 225 E Chicago Ave, Box 69, Chicago, IL 60611-2991 | 2007-01-12 |
| 1306825435 | Monica Kogan | Orthopaedic Surgery | 1611 W Harrison St, #400, Chicago, IL 60612-4861 | 2006-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831402007 | Verena Michaela Schreiber | Orthopaedic Surgery | 920 Milwaukee Ave, Lincolnshire, IL 60069 | 2010-07-16 |
| 1477726610 | J.e.bertolini,m.d. Sc. | Orthopaedic Surgery | 202 N Hammes Ave, Suite D, Joliet, IL 60435-8129 | 2008-04-09 |
| 1487879961 | Illinois Valley Community Hospital | Orthopaedic Surgery | 920 West St, Suite 211, Peru, IL 61354-2763 | 2007-04-17 |
| 1841230471 | Krishna Anjali Singh | Orthopaedic Surgery | 301 N 8th St, Pav4b, Springfield, IL 62701-1041 | 2006-06-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.