Individual
DR. RYAN BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
5465 GRAND AVE, GURNEE, IL 60031-4913
(847) 356-3322
Mailing address
420 W. GRAND AVE., LAKE VILLA, IL 60046
(847) 356-3322
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-008896
IL
104100000X
Social Worker
—
—
Other
Enumeration date
11/03/2010
Last updated
11/16/2016
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