Organization Active NPI

Bradley Wellness PLLC

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1023980984
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
BRADLEY WELLNESS PLLC
Practice address
11104 S Troy St
Chicago, IL 60655-2318
Phone
(773) 941-5125
Fax
(773) 352-4149
NPI assigned
Sep 20, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Vicki Bradley, NPNPI 1265130652
Title
Owner
Phone
(773) 679-4609

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

11104 S Troy St
Chicago, IL 60655-2318

Mailing address

11104 S Troy St
Chicago, IL 60655-2318
Phone (773) 679-4609

National Provider Directory

National Provider Directory

Locations

11104 S Troy St
Chicago, IL 60655
Phone (773) 941-5125

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1758326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762473600000",
    "number": "1023980984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11104 S TROY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606552318",
            "telephone_number": "773-679-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11104 S TROY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606552318",
            "telephone_number": "773-941-5125",
            "fax_number": "773-352-4149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-20",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-679-4609",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.