| Kevin Bradley, Lcsw, P.c. | |
|
175 E Hawthorn Pkwy 336 Vernon Hills IL 60061-1463 | |
| (847) 331-7907 | |
| Not Available |
| Full Name | Kevin Bradley, Lcsw, P.c. |
|---|---|
| Speciality | Social Worker |
| Location | 175 E Hawthorn Pkwy, Vernon Hills, Illinois |
| Authorized Official Name and Position | Kevin Bradley (PRESIDENT) |
| Authorized Official Contact | 8473317907 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Bradley, Lcsw, P.c. 175 E. Hawthorn Parkway 336 Vernon Hills IL 60061 Ph: (847) 331-7907 | Kevin Bradley, Lcsw, P.c. 175 E Hawthorn Pkwy 336 Vernon Hills IL 60061-1463 Ph: (847) 331-7907 |
| NPI Number | 1497999783 |
|---|---|
| Provider Enumeration Date | 04/30/2009 |
| Last Update Date | 04/30/2009 |
| Medicare PECOS PAC ID | 4486060787 |
|---|---|
| Medicare Enrollment ID | O20210311001344 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497999783 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149009486 (Illinois) | Primary |
| Provider Name | Kevin Bradley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588683809 PECOS PAC ID: 5395151690 Enrollment ID: I20210311001561 |
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