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Individual
BRADLEY COBB
Active
Individual
BRADLEY COBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125.078853
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/13/2019
Last updated
07/26/2021
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