Individual
MR. BRADLEY DORNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2606 W 104TH ST, CHICAGO, IL 60655-1605
(773) 443-0815
Mailing address
2606 W 104TH ST, CHICAGO, IL 60655-1605
(773) 443-0815
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.465731
IL
163W00000X
Registered Nurse
1105101-30
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
28294742A
IN
Other
Enumeration date
08/31/2023
Last updated
06/20/2025
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