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Contact Information

LISA A WHITTY BRADLEY, MD
7905 CALUMET AVE
MUNSTER, IN46321-2549
 Phone: 219-836-7506
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic and Reconstructive Surgery

2086S0122X 02 Physician/General Surgery
 

Plastic Surgery

208200000X 02 Physician/General Surgery
 

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for LISA A WHITTY BRADLEY · (Female)

NPI # 1801808662
Status Active
Credentials MD
Entity Individual
Enumeration date 08/12/2006
Last updated 03/16/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • IN License # 01079522A
  • IN License # 01079522B
  • IL Medicaid 0361102441
  • IL Other 7215166 BCBS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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