BRADLEY T BAGAN (NPI# 1346367190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346367190 |
| Entity Type | Individual |
| Full Name | BRADLEY T BAGAN |
| Credential | M.D. |
| Practice Address |
712 S Milwaukee Ave Libertyville IL 60048-3279 |
| Mailing Address |
Po Box 735 Lake Forest IL 60045-0735 |
| Practice Telephone | 8473621848 |
| Practice Fax Number | 8473623351 |
| Mailing Telephone | 3123181309 |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2014-10-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207T00000X | Neurological Surgery | D71456 | MD | Allopathic & Osteopathic Physicians |
| N | 207T00000X | Neurological Surgery | 38274 | IA | Allopathic & Osteopathic Physicians |
| Y | 207T00000X | Neurological Surgery | 036-114948 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
712 S MILWAUKEE AVE |
| City | LIBERTYVILLE |
| State | IL |
| Zip Code | 60048-3279 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093703571 | Jonathan S Citow | Neurological Surgery | 712 S Milwaukee Ave, Libertyville, IL 60048-3279 | 2005-10-10 |
| 1669932992 | Andrea Carolina Bermudez | Physician Assistant | 712 S Milwaukee Ave, Libertyville, IL 60048-3279 | 2019-03-22 |
| 1174099022 | Alexa Niermeyer | Physician Assistant | 712 S Milwaukee Ave, Libertyville, IL 60048-3279 | 2018-10-18 |
| 1770966848 | Andrew Joyce | Physician Assistant | 712 S Milwaukee Ave, Libertyville, IL 60048-3279 | 2015-07-07 |
| 1376971440 | Alexandra Vigilante | Physician Assistant | 712 S Milwaukee Ave, Libertyville, IL 60048-3279 | 2013-10-28 |
| 1710237748 | Justin W Jelinski | Physician Assistant | 712 S Milwaukee Ave, Libertyville, IL 60048-3279 | 2012-09-18 |
| 1629363064 | Lakeshore Physical Therapy, LLC | Clinic/Center | 712 S Milwaukee Ave, Lower Level, Libertyville, IL 60048-3279 | 2011-06-14 |
| 1811224785 | Lake County Imaging, LLC | Radiology | 712 S Milwaukee Ave, Libertyville, IL 60048-3279 | 2009-11-12 |
| 1922272830 | Juan C Alzate | Neurological Surgery | 712 S Milwaukee Ave, Libertyville, IL 60048-3279 | 2008-04-22 |
| 1912170523 | Libertyville Neurosurgery, LLC | Neurological Surgery | 712 S Milwaukee Ave, Libertyville, IL 60048-3279 | 2008-04-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184119950 | Park Avenue Dental Professionals, PC | Dentist | 1001 W. Park Avenue, Libertyville, IL 60048 | 2018-06-25 |
| 1437643525 | Shanna Coyle | Registered Nurse | 1128 Jaimee Ln, Libertyville, IL 60048 | 2018-06-21 |
| 1366943672 | Jackie Rayyan | Behavior Technician | 917 Sherwood Drive, Suite 201, Lake Bluff, IL 60048 | 2018-02-22 |
| 1851804850 | Mary E. Linsey | Counselor | 34180 Highway 45, Libertyville, IL 60048 | 2017-11-13 |
| 1962929018 | Affinity Integrated Healthcare | Chiropractor | 736 Florsheim Dr, St 12, Libertyville, IL 60048 | 2017-08-29 |
| 1164946471 | Christianna Patterson | Speech-Language Pathologist | 1870 W Winchester Rd #203, Libertyville, IL 60048 | 2017-07-28 |
| 1962938407 | Kyle Winiger | Specialist/Technologist | 4551 West Gavin Lane, Libertyville, IL 60048 | 2017-05-03 |
| 1396291530 | Karyn Kolner | Physical Therapist | 860 W Winchester Rd, #108, Libertyville, IL 60048 | 2016-08-28 |
| 1477900785 | Medlogic LLC | Clinic/Center | 114 West Rockland Road, Suite 201, Libertyville, IL 60048 | 2016-05-17 |
| 1477926343 | Robert Mcnulty | Student in an Organized Health Care Education/Training Program | 1313 Crane Blvd, Libertyville, IL 60048 | 2015-11-02 |
| Find all providers in zip 60048 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093703571 | Jonathan S Citow | Neurological Surgery | 712 S Milwaukee Ave, Libertyville, IL 60048-3279 | 2005-10-10 |
| 1922272830 | Juan C Alzate | Neurological Surgery | 712 S Milwaukee Ave, Libertyville, IL 60048-3279 | 2008-04-22 |
| 1912170523 | Libertyville Neurosurgery, LLC | Neurological Surgery | 712 S Milwaukee Ave, Libertyville, IL 60048-3279 | 2008-04-04 |
| 1225048804 | Robert Keith Erickson | Neurological Surgery | 712 S Milwaukee Ave, Libertyville, IL 60048-3279 | 2006-08-08 |
| 1942281126 | American Center for Spine & Neurosurgery LLC | Neurological Surgery | 712 S Milwaukee Ave, Libertyville, IL 60048-3279 | 2005-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871114371 | Justin Michael | Neurological Surgery | 701 N 1st St Ste D-319, Springfield, IL 62702-3757 | 2020-05-06 |
| 1023678638 | Matthew Weber | Neurological Surgery | 701 N 1st St, Suite D-319, Springfield, IL 61702 | 2019-06-17 |
| 1891281499 | Kamran Khan, Sc | Neurological Surgery | 1890 Silver Cross Blvd Ste 450, New Lenox, IL 60451-9518 | 2018-07-06 |
| 1881124030 | Denise Brunozzi | Neurological Surgery | 912 South Wood Street, 451 N - Hc 739, Chicago, IL 60612 | 2017-06-19 |
| 1407218365 | St Anthonys Physician Organization of Illinois | Neurological Surgery | 211 S Burns Ave, Sparta, IL 62286-1895 | 2016-03-22 |
| 1225455181 | Jehad Algharabli | Neurological Surgery | 2218 S Leavitt St, Chicago, IL 60608-4008 | 2014-03-27 |
| 1992041461 | Gursant Atwal | Neurological Surgery | University of Il Hospital & Health Science System, 1740 W Taylor St, Chicago, IL 60612 | 2013-01-02 |
| 1629321112 | James Bruce Mansfield | Neurological Surgery | 5 Loch Ln, South Barrington, IL 60010-9532 | 2012-10-21 |
| 1639445877 | Joseph R Rivas | Neurological Surgery | 511 W Belmont Ave, #32, Chicago, IL 60657-4663 | 2012-03-30 |
| 1356637722 | Melissa M Stamates | Neurological Surgery | 2650 Ridge Ave Fl 3, Evanston, IL 60201 | 2011-06-23 |
| Find all providers with the same taxonomy | ||||
| City | LIBERTYVILLE |
| Zip Code | 60048 |
Please comment or provide details below to improve the information on BRADLEY T BAGAN.
| 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.