DR. SAMANTHA ELIZABETH BRADLEY (NPI# 1639587942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639587942 |
| Entity Type | Individual |
| Full Name | DR. SAMANTHA ELIZABETH BRADLEY |
| Other Name | SAMANTHA ELIZABETH RACZKOWSKI |
| Credential | D.C. |
| Practice Address |
8115 Fruit Farm Rd Belvidere IL 61008-9075 |
| Practice Telephone | 8155476333 |
| Practice Fax Number | 8156425695 |
| Mailing Telephone | 8155476333 |
| Mailing Fax Number | 8156425695 |
| Enumeration Date | 2014-07-30 |
| Last Update Date | 2019-10-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 038012666 | IL | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | AETNA PROVIDER ID | 5090934 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 205 Cadillac Ct, Ste 8, Belvidere, IL 610081733 | 8155476333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659612109 | Samantha Caitlin Bradley | Behavioral Analyst | 2826 Amnicola Hwy, Chattanooga, TN 37406-3605 | 2013-03-08 |
| 1043668544 | Samantha Bradley | Clinic/Center | 1012 E Willetta St, Phoenix, AZ 85006-2749 | 2016-05-25 |
| 1730490038 | Samantha Marie Bradley | Counselor | 710 Burlington St, Holdrege, NE 68949-2177 | 2010-07-01 |
| Street Address |
8115 FRUIT FARM RD |
| City | BELVIDERE |
| State | IL |
| Zip Code | 61008-9075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811397136 | Generations Chiropractic Wellness, LLC | Clinic/Center | 8115 Fruit Farm Rd, Belvidere, IL 61008-9075 | 2014-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902322944 | Lynsie Merry | Speech-Language Pathologist | 919 E. Sixth St., Belvidere, IL 61008 | 2017-08-22 |
| 1023379773 | Dylen Adair Larsen | Technician/Technologist | 521 South Street, Suite 1, Belvidere, IL 61008 | 2012-05-30 |
| 1376665224 | Ultrasound of Belvidere LLC | Radiologic Technologist | 1006 Logan Avenue, Belvidere, IL 61008 | 2007-04-04 |
| 1992845093 | Vicki Marie Harrison | Chiropractor | 301 North State Street, Belvidere, IL 61008 | 2007-02-07 |
| 1316007859 | Drs Drake Ltd | Dentist | 515 Pearl Street, Belvidere, IL 61008 | 2006-12-12 |
| 1194898015 | Family Optical Centre Inc | Optometrist | 304 No State St, Belvidere, IL 61008 | 2006-11-16 |
| 1457373946 | Mary Simmons | Family Medicine | 1700 Henry Luckow Ln, Belvidere, IL 61008 | 2006-07-24 |
| 1134172166 | Gabriel John Javurek | Chiropractor | 1800 Logan Ave, Belvidere, IL 61008 | 2006-05-19 |
| 1437642535 | Bailey A Bolwerk | Physical Therapist | 1731 Henry Luckow Ln, Belvidere, IL 61008 | 2018-06-13 |
| 1184079451 | Amanda L Ritter | Nurse Practitioner | 1700 Henry Luckow Ln, Belvidere, IL 61008 | 2016-04-25 |
| Find all providers in zip 61008 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962943936 | Kelsey Botterman | Chiropractor | 9960 Poplar Grove Rd, Belvidere, IL 61008-8980 | 2017-03-10 |
| 1932547189 | Amy Elizabeth Hippard | Chiropractor | 998 Belvidere Rd Ste 3, Belvidere, IL 61008-9360 | 2013-06-10 |
| 1023312097 | Danielle E Anderson | Chiropractor | 3088 Flora Rd, Belvidere, IL 61008-9342 | 2011-01-05 |
| 1891939955 | Area Chiropractic Clinic Inc | Chiropractor | 301 N State St, Belvidere, IL 61008-3224 | 2009-04-20 |
| 1992845093 | Vicki Marie Harrison | Chiropractor | 301 North State Street, Belvidere, IL 61008 | 2007-02-07 |
| 1316009301 | Demetrios Agis Kydonieus | Chiropractor | 435 Buckhorn Dr, Belvidere, NJ 07823-2710 | 2006-12-15 |
| 1912073735 | Roger Allen Pope | Chiropractor | 1414 North State Street, Belvidere, IL 61008-2094 | 2006-11-24 |
| 1972673572 | Eric Rodriguez | Chiropractor | 337 Water St, Belvidere, NJ 07823-1218 | 2006-11-09 |
| 1629168612 | Rosemary Schiavi | Chiropractor | 12924 Wild Prairie Close, Belvidere, IL 61008-8500 | 2006-10-13 |
| 1578669263 | Jon P Heins | Chiropractor | 1 Brookfield Glen Dr, Suite B, Belvidere, NJ 07823-2854 | 2006-09-16 |
| Find all providers in BELVIDERE | ||||
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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.