MEDICARE: BRADLEY JOSEPH MCILNAY MD

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	2085R0202X	Diagnostic Radiology Physician	L3394	TX
2	2085R0202X	Diagnostic Radiology Physician	04-31921	KS
3	2085R0202X	Diagnostic Radiology Physician	2006013165	MO

Other Identifiers

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

General Provider Information

NPI Number	:	1558325282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRADLEY JOSEPH MCILNAY MD

Provider Business Mailing Address
First Line	:	5800 FOXRIDGE DR
Second Line	:	SUITE 240
City	:	MISSION
State	:	KS
Zip	:	66202-2333
Country	:	US
Telephone Number	:	913-261-3153
Fax Number	:	913-262-3295

Provider Business Practice Location Address
First Line	:	11011 HASKELL AVE
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66109-8500
Country	:	US
Telephone Number	:	913-667-5667
Fax Number	:	913-791-4219

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

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	08/01/2013

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