DR. TIMOTHY MICHAEL BRADLEY (NPI# 1568682508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568682508 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY MICHAEL BRADLEY |
| Credential | MD |
| Practice Address |
3310 W Main St Suite 200 St Charles IL 60175-1000 |
| Practice Telephone | 6308976044 |
| Practice Fax Number | 6306593502 |
| Mailing Telephone | 6308596800 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2015-07-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0105X |
Surgery Specialization: Surgery of the Hand |
036-082971 | IL | Allopathic & Osteopathic Physicians |
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
036-082971 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036-082971 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710274956 | Timothy Bradley | Contractor | 14330 E Spruce Circle, Talkeetna, AK 99676-0984 | 2011-07-08 |
| 1851394746 | Timothy Michael Bradley | Orthopaedic Surgery | 602 Vonderburg Dr, Suite 103, Brandon, FL 33511-5900 | 2005-05-24 |
| 1356997878 | Timothy Bradley | Student in an Organized Health Care Education/Training Program | 1 College Ave # Dif123, Williamsport, PA 17701-5778 | 2019-08-12 |
| 1922296433 | Timothy P Bradley | Pediatrics | 1 Elliot Way, Elliot Emergency Medicine, Manchester, NH 03103-3502 | 2007-10-09 |
| Street Address |
3310 W MAIN ST SUITE 200 |
| City | ST CHARLES |
| State | IL |
| Zip Code | 60175-1000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073512596 | Teresa L. Homan | Obstetrics & Gynecology | 3310 W Main St, Suite 200, St Charles, IL 60175-1000 | 2005-07-18 |
| 1689098261 | Meghan Anne Jones | Nurse Practitioner | 3310 W Main St, Suite 200, St Charles, IL 60175-1000 | 2014-02-18 |
| 1255625281 | Mark Kruszewski | Nurse Practitioner | 3310 W Main St, Suite 200, St Charles, IL 60175-1000 | 2011-06-07 |
| 1275796260 | Sarah Elizabeth Smith | Pediatrics | 3310 W Main St, Suite 200, St Charles, IL 60175-1000 | 2008-07-09 |
| 1316141203 | Thomas Dovidio | Pediatrics | 3310 W Main St, Suite 200, St Charles, IL 60175-1000 | 2007-06-13 |
| 1689888679 | Diane Bristol | Nurse Practitioner | 3310 W Main St, Suite 200, St Charles, IL 60175-1000 | 2007-05-09 |
| 1235358920 | Fox Valley Women & Children's Health Partners Ltd | Obstetrics & Gynecology | 3310 W Main St, Suite 200, St Charles, IL 60175-1000 | 2007-04-24 |
| 1720199409 | Carla Denise Adams | Optometrist | 3310 W Main St, Suite 180, St Charles, IL 60175-1000 | 2006-08-31 |
| 1992714463 | Adams Eyecare, PC | Optometrist | 3310 W Main St, Suite 180, St Charles, IL 60175-1000 | 2006-08-05 |
| 1710906235 | Natalie K Roche | Obstetrics & Gynecology | 3310 W Main St, Suite 200, St Charles, IL 60175-1000 | 2006-07-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740733138 | Ryan Paul Kuebler | Dentist | 40w320 La Fox Rd., Suite D, St Charles, IL 60175 | 2016-08-02 |
| 1346602554 | Erica Witkowski | Specialist/Technologist | 6n 370 Crescent Lane, Saint Charles, IL 60175 | 2016-03-26 |
| 1437495728 | Bradley S Murison | Physical Therapist | 3381 W State St., Suite 100, St Charles, IL 60175 | 2012-12-14 |
| 1942507355 | Fox River & Countryside Fire/rescue District | Ambulance | 35w350 Carl Lee Road, St Charles, IL 60175 | 2011-02-21 |
| 1871825984 | Fay E Jackson | Counselor | 3140 W Route 64, St. Charles, IL 60175 | 2010-02-01 |
| 1801126941 | Philip James Kocisko | Counselor | 3140 W. Route 64, Saint Charles, IL 60175 | 2010-01-13 |
| 1891971529 | Caroline M Bollentino | Speech-Language Pathologist | 40w310 La Fox Rd, Suite A1-b1, St Charles, IL 60175 | 2008-01-11 |
| 1770783599 | Joy O Urubusi | Psychiatry & Neurology | 3825 Campton Hills Road, St Charles, IL 60175 | 2007-07-19 |
| 1225236052 | Anna Almase Medina | Dentist | 2445 Dean, 1c, St Charles, IL 60175 | 2007-07-03 |
| 1467666453 | Shelly Sinatra | Nurse Practitioner | 3310 W. Main St, Suite 200, St. Charles, IL 60175 | 2007-05-09 |
| Find all providers in zip 60175 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467074617 | Dewolfe Aesthetic Services Sc | Surgery | 3357 N. Southport Aveune, Chicago, IL 60657 | 2020-05-11 |
| 1578068524 | Jw Operatory | Surgery | 1811 Saint Johns Ave Ste 100, Highland Park, IL 60035-5607 | 2018-03-29 |
| 1780198796 | Lin Plastic and Reconstructive Surgery Inc | Surgery | 730 W Couch Pl Unit 1409, Chicago, IL 60661-1383 | 2017-11-29 |
| 1750892923 | Alban Ingram Miller Jr. | Surgery | 1708 Foxborough Ct, Champaign, IL 61822-8503 | 2017-10-16 |
| 1972905545 | Jennifer Hein | Surgery | 2631 Williamsburg Ave Ste 102, Geneva, IL 60134-1108 | 2014-09-25 |
| 1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
| 1043559842 | Msa Alliance, LLC | Surgery | 1 Broadway Plz, Sparta, IL 62286-1800 | 2013-02-14 |
| 1518223791 | Hansel M Debartolo Jr Md Sc | Surgery | 11 Debartolo Dr., Sugar Grove, IL 60554 | 2012-04-02 |
| 1952692717 | Georgios Kokosis | Surgery | 1725 W Harrison St Ste 425, Chicago, IL 60612-3893 | 2011-04-28 |
| 1740596808 | Swedishamerican Hospital | Surgery | 6533 Lexus Dr, Rockford, IL 61108 | 2010-08-27 |
| Find all providers with the same taxonomy | ||||
| City | ST CHARLES |
| Zip Code | 60175 |
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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.