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NPI Code Detail

MEDICARE: PETER A BRADY M.D.

MEDICARE: PETER A BRADY M.D.
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
1207RC0000XCardiovascular Disease Physician39616MN
2207RC0001XClinical Cardiac Electrophysiology Physician39616MN
3207RC0001XClinical Cardiac Electrophysiology Physician036149204IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215901301
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER A BRADY M.D.
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1293
Country : US
Telephone Number : 847-390-5900
Fax Number :
Provider Business Practice Location Address
First Line : 3134 N CLARK ST
Second Line :
City : CHICAGO
State : IL
Zip : 60657-4414
Country : US
Telephone Number : 773-880-9722
Fax Number : 773-880-9723
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2006
Last Update Date : 05/19/2022

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Directions to “ PETER A BRADY M.D.” Practice Location

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