Connor Joseph Bradley, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038013824 Issued in IL

Practice address

3733 S State Route 159
Glen Carbon, IL 62034-3043

Phone

(618) 288-8090

NPI assigned

Jan 19, 2022

Last updated

Jan 19, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1164174462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 N 2ND ST",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620251073",
            "telephone_number": "618-781-5285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3733 S STATE ROUTE 159",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620343043",
            "telephone_number": "618-288-8090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2266 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Granite City",
            "state": "IL",
            "postal_code": "620404705",
            "country_code": "US",
            "telephone_number": "618-876-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "CONNOR",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038013824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alana Bollone, PA
• Eric Joseph Bomba
• Amber Bond
• Patricia Bortko
• Paige Hope Bowman
• Crystal Bradley, FNP-C, FPA
• Todd M Brammeier, D.M.D.
• Rebecca Allison Brand, LCPC
• Briana L. Oller, D.M.D., P.C. (Simply Smiles)
• Rachel Ohannah Britton, RBT

• Chiropractor in Glen Carbon, IL
• Providers in Glen Carbon, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.