ROSSLEY BRADLEY NPI 1003446477

Specialist/Technologist Cardiovascular (Sonography) in Matteson, IL

Individual Male Specialist/Technologist Cardiovascular Sonography

About ROSSLEY BRADLEY

Rossley Bradley is a provider established in Matteson, Illinois and his medical specialization is specialist/technologist cardiovascular. The NPI number of Rossley Bradley is 1003446477 and was assigned on January 2020. The practitioner's primary taxonomy code is 246XS1301X. The provider is registered as an individual and his NPI record was last updated January 2020.

NPI

1003446477

Provider Name ROSSLEY BRADLEY
Provider Location Address4557 LINCOLN HWY MATTESON, IL 60443
Provider Mailing Address1001 EAGLE POINT DR MATTESON, IL 60443
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date01-24-2020
Last Update Date01-24-2020

Primary Taxonomy

Taxonomy Code246XS1301X
ClassificationSpecialist/Technologist Cardiovascular
TypeTechnologists, Technicians & Other Technical Service Providers
SpecializationSonography

Business Address

ROSSLEY BRADLEY
4557 LINCOLN HWY
MATTESON, IL
ZIP 60443
Phone: (855) 494-2600
Fax: (855) 918-1906

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Mailing Address

ROSSLEY BRADLEY
1001 EAGLE POINT DR
MATTESON, IL
ZIP 60443
Phone: (708) 691-6123
Fax: (855) 918-1906

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.