Individual
BRADLEY H. GLEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 624-8750
(309) 624-8552
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 624-8750
(309) 624-8552
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036-118441
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036118441
—
IL
01
—
809840
MEDICARE GROUP #
—
Enumeration date
01/04/2007
Last updated
02/22/2016
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