| Organization Name: | BRADLEY S. ROSS, D.P.M., P.C. |
| NPI Number: | 1194993956 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRADLEY S ROSS (PRESIDENT) |
| Mailing Address: | 7126 N Lincoln Ave Lincolnwood |
| State: | IL US |
| Postal Code: | 607122234 |
| Phone Number: | 8476731818 |
| Fax Number: | 8475839196 |
| NPI Enumeration Date: | 02/14/2008 |
| NPI Last Update Date: | 07/09/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | 016-004242 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |