Organization
BRADFORD CHIROPRACTIC AND ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGG S BRADFORD DC (CHIROPRACTOR)
(773) 631-6161
Entity
Organization
Contact information
Practice address
6237 W TOUHY AVE, CHICAGO, IL 60646-1106
(773) 631-6161
(773) 631-7380
Mailing address
6237 W TOUHY AVE, CHICAGO, IL 60646-1106
(773) 631-6161
(773) 631-7380
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
060-005405
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16-18-745
BCBS
IL
01
—
4349426
AETNA
IL
Enumeration date
01/08/2008
Last updated
04/18/2012
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