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General NPI Number Information
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NPI Number | 1366813594
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Entity Type | Individual
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Provider Name | STEPHANIE G BRADLEY-MILLER APRN, CNP
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Gender | Female
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Dates
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Enumeration Date | 10/14/2015
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 676 N SAINT CLAIR ST ARKES 2140
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City | CHICAGO
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State | IL
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Zip | 60611-2927
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Country | US
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Telephone | 312-664-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 675 N SAINT CLAIR ST STE 21-100
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City | CHICAGO
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State | IL
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Zip | 60611-5970
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Country | US
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Telephone | 312-695-6180
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Fax | 312-695-6189
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209013289
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License Number State | IL
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