| Doctor Name: | MICHAEL W. BRADBURN |
| NPI Number: | 1205140811 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | |
| Business Practice Address: | 1819 Bay Scott Cir Suite 109 Naperville, IL - 605401129 |
| Business Phone Number: | 6303572456 |
| Business Fax Number: | 6303572482 |
| Mailing Address: | 1819 Bay Scott Cir, Suite 109 NAPERVILLE |
| State: | IL |
| Postal Code: | 605401129 |
| Phone Number: | 6303572456 |
| Fax Number: | 6303572482 |
| NPI Enumeration Date: | 08/06/2010 |
| NPI Last Update Date: | 08/01/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |