Provider Demographics
NPI:1477090363
Name:TRAD, PIERRE
Entity Type:Individual
Prefix:
First Name:PIERRE
Middle Name:
Last Name:TRAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9211 N TRIGGER RD
Mailing Address - Street 2:
Mailing Address - City:EDWARDS
Mailing Address - State:IL
Mailing Address - Zip Code:61528-9618
Mailing Address - Country:US
Mailing Address - Phone:309-678-7685
Mailing Address - Fax:
Practice Address - Street 1:9211 N TRIGGER RD
Practice Address - Street 2:9211 N TRIGGER RD
Practice Address - City:EDWARDS
Practice Address - State:IL
Practice Address - Zip Code:61528-9618
Practice Address - Country:US
Practice Address - Phone:309-678-7685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide