BRADY JAY COBURN (NPI# 1811491202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811491202 |
| Entity Type | Individual |
| Full Name | BRADY JAY COBURN |
| Credential | MD |
| Practice Address |
2160 S 1st Ave Maywood IL 60153 |
| Mailing Address |
2160 S 1st Ave Maywood IL 60153-3328 |
| Practice Telephone | 7083273041 |
| Mailing Telephone | 7083273041 |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2018-06-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | 125.072863 | IL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | IL | Student, Health Care |
| Street Address |
2160 S 1ST AVE |
| City | MAYWOOD |
| State | IL |
| Zip Code | 60153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174525489 | Michael Jm Raffin | Audiologist | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2005-06-01 |
| 1366049900 | Kenneth Bernard Jordan | Psychiatry & Neurology | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-10-06 |
| 1124634712 | Abhilasha Nitin Borkar | Pathology | 2160 S 1st Ave, Maywood, IL 60153 | 2020-09-18 |
| 1306450325 | Linda Ippolito | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-09-08 |
| 1194339135 | Meghan Henry | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-09-08 |
| 1194339911 | Victoria Leah Drozd | Student in an Organized Health Care Education/Training Program | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-08-31 |
| 1396357588 | Madison Schaefer | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-08-19 |
| 1134731375 | Otanthia S Williams-brady | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-08-19 |
| 1205454287 | Janet Nickels | Audiologist | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-07-07 |
| 1417574054 | Kathryn Clemans | Nurse Anesthetist, Certified Registered | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-06-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053933077 | Judie Noemie Hoilat | Internal Medicine | 2160 S 1st Avenue, Maywood, IL 60153 | 2020-05-13 |
| 1457972457 | Yuchen Zheng | Student in an Organized Health Care Education/Training Program | Department of Neurology, Loyola University Medical Cent, 2160 S. First Ave, Maywood, IL 60153 | 2020-04-30 |
| 1437779519 | Amna Amad Siddiqui | Student in an Organized Health Care Education/Training Program | 2160 S. First Avenue, Loyola University Medical Center, Maywood, IL 60153 | 2020-04-20 |
| 1982232211 | Brian Kurtz | Student in an Organized Health Care Education/Training Program | 2160 S First Ave, Bulding 105-suite 2840a, Maywood, IL 60153 | 2020-03-31 |
| 1902434947 | Saadiya Jabbar | Psychiatry & Neurology | Loyola University Medical Center, Building 105, Suite 1940, Maywood, IL 60153 | 2020-03-27 |
| 1558919472 | Linda Sue Moton | Technician | 10 South 15 Apt. 1, Maywood, IL 60153 | 2019-09-04 |
| 1760047518 | Braden Robert Dasovic | Student in an Organized Health Care Education/Training Program | 2160 S. First Avenue Building 105/room 2700, Department, Loyola Medical Center, Maywood, IL 60153 | 2019-05-07 |
| 1134680713 | Madeline Shaoyun Tiee | Orthopaedic Surgery | Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL 60153 | 2019-03-27 |
| 1538629746 | Michael Murphy | Orthopaedic Surgery | 2160 S 1st Ave., Maguire Center, Dept of Ortho Surg, Maywood, IL 60153 | 2019-03-22 |
| 1053871681 | Michael V Padua | Psychiatry & Neurology | 2160 S 1st Ave Bldg, Maywood, IL 60153 | 2019-03-20 |
| Find all providers in zip 60153 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265060891 | Bianca Adele Di Chiaro | Plastic Surgery | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-03-30 |
| 1558821108 | Adam T Gould | Plastic Surgery | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2019-03-20 |
| 1912380718 | Joel Bronstein | Plastic Surgery | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2015-06-30 |
| 1619227774 | Frank Ciminello Medical, PC | Plastic Surgery | 113 W Essex St Ste 204, Maywood, NJ 07607-1023 | 2012-09-17 |
| 1811124274 | Candice Marie Leach | Plastic Surgery | 2160 S 1st Ave, Bldg. 110-room 3210, Maywood, IL 60153-3328 | 2009-06-12 |
| 1134382120 | Lohith Bose | Plastic Surgery | 2160 S 1st Ave, Ems Bldg 110, Room 3210, Maywood, IL 60153-3328 | 2008-07-09 |
| 1144403791 | Victor A Moon | Plastic Surgery | 2160 S 1st Ave, Ems 110, Rm 3293, Maywood, IL 60153-3328 | 2007-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093363236 | Stephen A Madry Md | Plastic Surgery | 27750 W Il Route 22 Ste 230, Barrington, IL 60010-1924 | 2019-08-30 |
| 1588129928 | Rosett Plastic Surgery, LLC | Plastic Surgery | 1149 Crofton Ave N, Highland Park, IL 60035-3953 | 2019-02-08 |
| 1922572411 | Plastic Surgery Services and Equipment LLC | Plastic Surgery | 3050 Finley Rd Ste 300b, Downers Grove, IL 60515-1369 | 2019-01-17 |
| 1710487095 | Bradley Ashpole Md LLC | Plastic Surgery | 501 W Golf Rd Ste A, Schaumburg, IL 60195-3502 | 2018-02-13 |
| 1821501586 | Plastic Surgery Clinic of Chicago LLC | Plastic Surgery | 850 S Wabash Ave Ste 310, Chicago, IL 60605-3642 | 2017-11-15 |
| 1720500085 | Warner Aesthetic & Reconstructive Institute | Plastic Surgery | 570 Lincoln Ave Lowr Level4, Winnetka, IL 60093-2355 | 2017-07-08 |
| 1902258874 | Rashid Plastic Surgery, LLC | Plastic Surgery | 804 W Trailcreek Drive, Peoria, IL 61614 | 2016-07-05 |
| 1073977369 | Subramaniam Arumugam | Plastic Surgery | 13020 S Winnebago Rd, Palos Heights, IL 60463-2056 | 2016-04-12 |
| 1598123424 | Craig Bradley | Plastic Surgery | 1035 W Rundell Pl, Chicago, IL 60607-2514 | 2016-02-06 |
| 1215346325 | Damian Gress | Plastic Surgery | 943 W 14th Pl, Unit 2 B, Chicago, IL 60608-2287 | 2014-08-04 |
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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.