Whitty Bradley, Lisa Ann

Whitty Bradley, Lisa Ann is an sole proprietor health care provider with primary practice located at 7905 Calumet Ave , Munster IN 46321-2549. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Plastic Surgery, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery is her primary health care specialty. Whitty Bradley, Lisa Ann can be contacted via phone (219) 836-7506.

Contact Information

Primary practice address
7905 Calumet Ave Munster IN 46321-2549
Phone: (219) 836-7506
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 01079522B Indiana
Allopathic & Osteopathic Physicians / Surgery 208600000X 01079522A Indiana
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X 01079522A Indiana

Profile Details

NPI number 1801808662
LBN Legal business name Whitty Bradley, Lisa Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 12th, 2006
Last updated Mar 16th, 2021 - about 5 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 1801808662 NPPES
Illinois MEDICAID 0361102441
Illinois Other 7215166

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