MEDICARE: CHAD M BRADY OTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	056014984	IL

General Provider Information

NPI Number	:	1487381927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAD M BRADY OTD

Provider Business Mailing Address
First Line	:	2122 YORK RD STE 300
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1925
Country	:	US
Telephone Number	:	630-575-6200
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 N LA SALLE ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60601-1206
Country	:	US
Telephone Number	:	312-855-9206
Fax Number	:	312-855-9210

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2022
Last Update Date	:	08/09/2022

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