Individual
BRADLEY THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN-CNP
Contact information
Practice address
1802 S MATTIS AVE, CHAMPAIGN, IL 61821-5923
(217) 365-2855
Mailing address
611 W PARK ST, URBANA, IL 61801-2501
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209021514
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209021514
IL
Other
Enumeration date
03/19/2020
Last updated
12/15/2025
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