Individual
BRADLEY OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
530 NE GLEN OAK AVE, #5607 NORTH BUILDING, PEORIA, IL 61637-0001
(309) 655-3863
Mailing address
530 NE GLEN OAK AVE, 5607 NORTH BUILDING, PEORIA, IL 61637-0001
(309) 655-3863
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125065833
IL
208000000X
Pediatrics Physician
Primary
125065833
IL
Other
Enumeration date
06/26/2014
Last updated
06/26/2014
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