Individual
GREGG S BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
6237 W TOUHY AVE, CHICAGO, IL 60646
(773) 631-6161
(773) 631-7380
Mailing address
6237 W TOUHY AVE, CHICAGO, IL 60646
(773) 631-6161
(773) 631-7380
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1618745
BCBS
IL
01
—
4349426
AETNA
IL
Enumeration date
11/14/2006
Last updated
02/28/2008
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