Provider Demographics
NPI:1467478552
Name:HAYASHI, BRADLEY HIROSHI (DC)
Entity Type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:HIROSHI
Last Name:HAYASHI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 IRVING PARK RD
Mailing Address - Street 2:
Mailing Address - City:HANOVER PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60133
Mailing Address - Country:US
Mailing Address - Phone:630-837-8900
Mailing Address - Fax:630-837-8984
Practice Address - Street 1:1802 IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:HANOVER PARK
Practice Address - State:IL
Practice Address - Zip Code:60133
Practice Address - Country:US
Practice Address - Phone:630-837-8900
Practice Address - Fax:630-837-8984
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038009091111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL90736Medicare ID - Type Unspecified
U83287Medicare UPIN