DR. RYAN BRADLEY (NPI# 1700187036) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700187036 |
| Entity Type | Individual |
| Full Name | DR. RYAN BRADLEY |
| Credential | PSYD |
| Practice Address |
5465 Grand Ave Gurnee IL 60031-4913 |
| Mailing Address |
420 W. Grand Ave. Lake Villa IL 60046 |
| Practice Telephone | 8473563322 |
| Mailing Telephone | 8473563322 |
| Enumeration Date | 2010-11-03 |
| Last Update Date | 2016-11-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
071-008896 | IL | Behavioral Health & Social Service Providers |
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831641877 | Ryan Bradley | Dentist | 3500 Black Forest Dr Ste 1, Fayetteville, AR 72704-6551 | 2016-10-25 |
| 1790154664 | Ryan Bradley | Physician Assistant | 5880 N Hospital Dr, Globe, AZ 85501 | 2015-09-21 |
| 1649544107 | Ryan Bradley | Pharmacist | 6348 Ne Halsey St Ste A, Portland, OR 97213-4720 | 2012-03-01 |
| 1306058805 | Ryan James Bradley | Anesthesiology | 332 Hermann St, San Francisco, CA 94117-3417 | 2007-05-04 |
| 1619965753 | Ryan David Bradley | Naturopath | 1307 N 45th St, Seattle, WA 98103-6704 | 2005-10-12 |
| 1871118075 | Ryan Bradley | Specialist/Technologist, Other | 4600 S Ulster St Ste 1225, Denver, CO 80237-2696 | 2020-06-12 |
| 1902458599 | Ryan Michael Bradley | Dentist | 19129 Beavercreek Rd, Oregon City, OR 97045-9539 | 2019-07-12 |
| 1194295022 | Ryan Bradley | Nurse's Aide | 6460 Harrison Ave, Cincinnati, OH 45247-7957 | 2018-12-04 |
| 1306341268 | Ryan Matthew Bradley | Student in an Organized Health Care Education/Training Program | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2018-03-23 |
| 1407227267 | Ryan Bradley | Case Manager/Care Coordinator | 225 S Main St, Hope, AR 71801-4319 | 2015-10-19 |
| Street Address |
5465 GRAND AVE |
| City | GURNEE |
| State | IL |
| Zip Code | 60031-4913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154671030 | Allendale Association | Clinic/Center | 5465 Grand Ave, 101, Gurnee, IL 60031-4913 | 2012-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881174720 | Rockelle Waggoner | Behavioral Analyst | 489 Tanglewood Dr, Gurnee, IL 60031 | 2018-08-20 |
| 1316434376 | Lake County Internal Medicine Assoc LLC | Non-Pharmacy Dispensing Site | 15 Tower Ct., Ste 190, Gurnee, IL 60031 | 2018-04-16 |
| 1588163364 | Advanced Endodontics, PC | Dentist | 103 S. Greenleaf Street, Suite K, Gurnee, IL 60031 | 2018-02-07 |
| 1578081550 | Northshore Medical Consultants, Ltd | Family Medicine | 1425 Hunt Club Rd. #302, Gurnee, IL 60031 | 2017-08-30 |
| 1336678739 | Sarah Beth Fugelseth | Nurse Practitioner | 1445 N Hunt Club Rd Ste 304, Gurnee, IL 60031 | 2017-06-08 |
| 1174079867 | Lifecarepros, LLC | In Home Supportive Care | 223 North Route 21, Gurnee, IL 60031 | 2016-09-01 |
| 1740733195 | Ryan Lee Winslow | Chiropractor | 6021 Washington St, Unit B, Gurnee, IL 60031 | 2016-08-02 |
| 1891129599 | Smart Scan Mri, LLC | Clinic/Center | 350 S. Greenleaf, Suite 401, Gurnee, IL 60031 | 2013-08-29 |
| 1568720076 | Yudelca Romano | Genetic Counselor, MS | 1125 Tri State Parkway, Gurnee, IL 60031 | 2012-05-03 |
| 1558637348 | Laura E Novak | Social Worker | 4212 Old Grand Avenue, Gurnne, IL 60031 | 2012-03-27 |
| Find all providers in zip 60031 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336633627 | Katie Salyer Szostak | Psychologist | 638 Ravinia Dr, Gurnee, IL 60031-4092 | 2018-06-19 |
| 1033607031 | Mark A Zissman | Psychologist | 222 S Greenleaf St Ste 106, Gurnee, IL 60031-5705 | 2018-04-25 |
| 1780082396 | Jennifer Nierstheimer | Psychologist | 200 S Greenleaf St Ste 200, Gurnee, IL 60031-3398 | 2014-12-12 |
| 1922392216 | Brandy Wolff Crandall | Psychologist | 200 S Greenleaf St Ste E, Gurnee, IL 60031 | 2011-06-03 |
| 1538487111 | Lori Ann Jensen | Psychologist | 135 N Greenleaf Ave., Suite 228, Gurnee, IL 60031-3393 | 2010-05-06 |
| 1831228659 | Georgette Hein | Psychologist | 135 N. Greenleaf, Suite 228, Gurnee, IL 60031 | 2007-03-05 |
| 1720117641 | Barry James Hoffman | Psychologist | 4212 Old Grand Ave, Suite 102, Gurnee, IL 60031-2708 | 2007-03-05 |
| 1568563203 | Randa Mary Anderson | Psychologist | 5101 Washington St Ste 1102, Gurnee, IL 60031-2988 | 2006-09-26 |
| 1043313216 | Behavioral Medicine Specialists, Inc. | Psychologist | 1445 N Hunt Club Rd Ste 101, Gurnee, IL 60031-2603 | 2006-09-06 |
| 1811946106 | Patricia Ryan | Psychologist | 5445 Grand Ave., Ste. 206, Gurnee, IL 60031 | 2006-05-06 |
| Find all providers in GURNEE | ||||
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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.