Provider Demographics
NPI:1699773101
Name:EPSTEIN, BRAD L (MD)
Entity type:Individual
Prefix:DR
First Name:BRAD
Middle Name:L
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2350 ROYAL BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-4719
Mailing Address - Country:US
Mailing Address - Phone:847-931-4747
Mailing Address - Fax:847-931-9602
Practice Address - Street 1:2350 ROYAL BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4719
Practice Address - Country:US
Practice Address - Phone:847-931-4747
Practice Address - Fax:847-931-9602
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL903880Medicare ID - Type Unspecified
ILE18974Medicare UPIN