MEDICARE: MR. ARNELL A. BRADY M.A., CCC-SLP/L

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	235Z00000X	Speech-Language Pathologist	146.003238	IL
2	235Z00000X	Speech-Language Pathologist	SLP005099	GA
3	235Z00000X	Speech-Language Pathologist	SP#2227	AR
4	235Z00000X	Speech-Language Pathologist	SP13298	CA
5	235Z00000X	Speech-Language Pathologist	22002765A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0001671540	OTHER	IL	INSURANCE

General Provider Information

NPI Number	:	1912081324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ARNELL A. BRADY M.A., CCC-SLP/L

Provider Business Mailing Address
First Line	:	1424 E 53RD ST
Second Line	:	SUITE 307
City	:	CHICAGO
State	:	IL
Zip	:	60615-4500
Country	:	US
Telephone Number	:	773-493-4000
Fax Number	:	773-493-4003

Provider Business Practice Location Address
First Line	:	1424 E 53RD ST
Second Line	:	SUITE 307
City	:	CHICAGO
State	:	IL
Zip	:	60615-4500
Country	:	US
Telephone Number	:	773-493-4000
Fax Number	:	773-493-4003

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

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	05/24/2013

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Directions to “ MR. ARNELL A. BRADY M.A., CCC-SLP/L” Practice Location

Language	Start Address	Practice Location

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