| Amanda Bradke, | |
|
1700 W Van Buren St Ste 500, Chicago, IL 60612 | |
| (312) 942-4200 | |
| Not Available |
| Full Name | Amanda Bradke |
|---|---|
| Gender | Female |
| Speciality | Internal Medicine |
| Experience | 12 Years |
| Location | 1700 W Van Buren St Ste 500, Chicago, Illinois |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518200468 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208M00000X | Hospitalist | 036-146767 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Rush University Medical Center | Chicago, IL | Hospital |
| Fort Defiance Indian Hospital | Fort defiance, AZ | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| The Fort Defiance Indian Hospital Board, Incorporation | 0941336697 | 104 |
| Rush University Medical Group | 5496658874 | 1134 |
| Entity Name | The Fort Defiance Indian Hospital Board, Incorporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477876639 PECOS PAC ID: 0941336697 Enrollment ID: O20100429001153 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Bradke, 1700 W Van Buren St Ste 500, Chicago, IL 60612-5500 Ph: (312) 942-4200 | Amanda Bradke, 1700 W Van Buren St Ste 500, Chicago, IL 60612 Ph: (312) 942-4200 |
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