Brady, Ashanta

Brady, Ashanta is an individual health care provider with primary practice located at 1950 W Polk St Ste 5210 , Chicago IL 60612-3723. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Brady, Ashanta can be contacted via phone (312) 864-0390.

Contact Information

Primary practice address
1950 W Polk St Ste 5210 Chicago IL 60612-3723
Phone: (312) 864-0390
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036.170779 Illinois
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036.170779 Illinois

Profile Details

NPI number 1245852169
LBN Legal business name Brady, Ashanta
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 13th, 2020
Last updated Jun 28th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245852169 NPPES
Illinois Other 036.170779 DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION

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