Provider Demographics
NPI:1326181967
Name:RULE, BRADLEY C (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:C
Last Name:RULE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6475 WASHINGTON ST
Mailing Address - Street 2:STE 101
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-4404
Mailing Address - Country:US
Mailing Address - Phone:847-662-7717
Mailing Address - Fax:
Practice Address - Street 1:6475 WASHINGTON ST
Practice Address - Street 2:STE 101
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-4404
Practice Address - Country:US
Practice Address - Phone:847-662-7717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0209851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice