Bradley Ashpole MD LLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

036113854 Issued in IL

Legal business name

BRADLEY ASHPOLE MD LLC

Practice address

1107 N Prospect Ave
Itasca, IL 60143-1408

Phone

(847) 884-8346

NPI assigned

Feb 13, 2018

Last updated

May 10, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bradley Ashpole, MDNPI 1457516866

Title

President/Ceo

Phone

(847) 884-8346

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bradley Lane Ashpole, M.D.

  • Plastic Surgery Physician
  • Itasca, IL
  • NPI 1457516866
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715299200000",
    "number": "1710487095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 W ESTATE LN E",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600453623",
            "telephone_number": "847-650-5818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 N PROSPECT AVE",
            "city": "ITASCA",
            "state": "IL",
            "postal_code": "601431408",
            "telephone_number": "847-884-8346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY ASHPOLE MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-13",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A",
        "authorized_official_last_name": "ASHPOLE",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "847-884-8346",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": "036113854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Plastic Surgery Physician in Itasca, IL
• Providers in Itasca, IL by specialty
• Plastic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.