Betty Coleman-Bradley
Individual provider Active NPI Family Nurse Practitioner · Harvey, IL
NPI 1255907283 · NPPES record last updated Jun 10, 2022
Key facts
- NPI
- 1255907283
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209.023246 (IL)
- Practice address
- 31 W 155TH St
Harvey, IL 60426-3556 - Phone
- (708) 596-5177
- Fax
- (708) 596-5518
- NPI assigned
- Jun 1, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mount Sinai Community Foundation
Practice addresses (Care Compare)
California Ave at 15TH St
Chicago, IL 60608-1858
Phone (773) 542-2000
Hospital & facility affiliations
- Holy Cross Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210621001523 | IL | Practitioner - Nurse Practitioner | 5193125631 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.023246 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mount Sinai Community Foundation | Current |
Accepting new patients | |
| Family Christian Health Center | Current |
Accepting new patients | |
| Midwest Express Care 2, Inc | Current |
Accepting new patients | |
| Christian Community Health Center | Current |
Accepting new patients | |
| Mount Sinai Community Foundation | Current |
Accepting new patients | |
| Christian Community Health Center | Current | Accepting new patients | |
| Christian Community Health Center | Current |
Accepting new patients | |
| Midwest Express Care 2, Inc | Current |
Accepting new patients | |
| Vitae Health Medical Illinois, PLLC | Current |
Accepting new patients | |
| Family Christian Health Center | Current | Accepting new patients | |
| Mount Sinai Community Foundation | Current | Accepting new patients | |
| CMC Healthcare LLC | Current |
Accepting new patients | |
| Family Christian Health Center | Current |
Accepting new patients |
Locations
422 E 4th St S
Arcola, IL 61910
Phone (217) 268-3022
8100 S Harlem Ave
Bridgeview, IL 60455
Phone (708) 594-5440
364 Torrence Ave
Calumet City, IL 60409
Phone (708) 868-9457
26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900
9718 S Halsted St
Chicago, IL 60628
Phone (773) 233-4100
2451 W Touhy Ave
Chicago, IL 60645
Phone (312) 593-5599
2425 E 71st St
Chicago, IL 60649
Phone (773) 721-5000
303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347
2201 Main St
Evanston, IL 60202
Phone (847) 905-3000
31 W 155th St
Harvey, IL 60426
Phone (708) 596-5177
940 Maple Rd
Homewood, IL 60430
Phone (708) 799-0244
200 Martin Ave
Naperville, IL 60540
Phone (630) 236-8018
6300 W 95th St
Oak Lawn, IL 60453
Phone (708) 599-4981
3450 Oakton St
Ste 300
Skokie, IL 60076
40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209.023246 | IL | Yes |
Addresses
Primary practice location
31 W 155TH St
Harvey, IL 60426-3556
Mailing address
31 W 155TH St
Harvey, IL 60426-3556
Phone (708) 596-5177
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 209023246 | Medicaid | IL |
Other providers in Harvey, IL
- Joseph M Civantos
- Clarence Johnson Transportation Inc
- Ralph Clark
- Jack A Cohen
- Tonya Echols Cole
- Rashonda Collins
- Community Dialysis LLC
- Comprehensive Health Agency Nurturing Guest Enervation
- Comprehensive Pain Care SC
- Mary G Conway
All providers in Harvey, IL · Family Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.