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Individual

CHARLES BRADLEY SCHUBERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1950 N HARLEM AVE, ELMWOOD PARK, IL 60707-3717
(708) 453-6800
(708) 453-3235
Mailing address
1950 N HARLEM AVE, ELMWOOD PARK, IL 60707
(708) 453-6800
(708) 453-3985

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036097485
IL
2086S0129X
Vascular Surgery Physician
Primary
036097485
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
36097485
IL
01
971720
MEDICARE
IL
Enumeration date
01/13/2006
Last updated
04/27/2022
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