Provider Demographics
NPI:1619149572
Name:SETCHELL, BRADLEY J (DC)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:J
Last Name:SETCHELL
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 1:2522 E LINCOLNWAY STE G
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:IL
Mailing Address - Zip Code:61081-3058
Mailing Address - Country:US
Mailing Address - Phone:815-866-5029
Mailing Address - Fax:815-626-6796
Practice Address - Street 1:2522 E LINCOLNWAY STE G
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:IL
Practice Address - Zip Code:61081-3058
Practice Address - Country:US
Practice Address - Phone:815-866-5029
Practice Address - Fax:815-626-6796
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011042111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038-01104201Medicaid
IL09821954OtherBCBS-IL
IL038-01104201Medicaid