Healthcare Provider Details
I. General information
NPI: 1881012383
Provider Name (Legal Business Name): BRADLEY JOHN ZARLING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/01/2014
Last Update Date: 11/18/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1221 N HIGHLAND AVE
AURORA IL
60506-1404
US
IV. Provider business mailing address
2357 SEQUOIA DR
AURORA IL
60506-6222
US
V. Phone/Fax
- Phone: 630-859-8700
- Fax:
- Phone: 630-907-3967
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XX0801X |
| Taxonomy | Orthopaedic Trauma Physician |
| License Number | 036.151642 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XS0114X |
| Taxonomy | Adult Reconstructive Orthopaedic Surgery Physician |
| License Number | 125.0734457 |
| License Number State | IL |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0114X |
| Taxonomy | Adult Reconstructive Orthopaedic Surgery Physician |
| License Number | 036.151642 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: