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General NPI Number Information
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NPI Number | 1649589938
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Entity Type | Individual
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Provider Name | BRADLEY M APPELHANS PHD
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Gender | Male
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Dates
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Enumeration Date | 10/04/2010
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Last Update Date | 10/04/2010
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Provider Practice Location Address
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Address Line | 1700 W VAN BUREN ST STE 470 RUSH UNIVERSITY PREVENTION CENTER
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City | CHICAGO
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State | IL
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Zip | 60612-3291
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Country | US
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Telephone | 312-942-3133
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Fax | 312-942-8119
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Provider Business Mailing Address
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Address Line | 1700 W VAN BUREN ST STE 470 DEPARTMENT OF PREVENTIVE MEDICINE, RUSH UNIVERSITY
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City | CHICAGO
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State | IL
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Zip | 60612-3291
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Country | US
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Telephone | 312-942-3477
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Fax | 312-942-8119
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071007986
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4051
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License Number State | AZ
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