Provider Demographics
NPI:1649589938
Name:APPELHANS, BRADLEY M (PHD)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:M
Last Name:APPELHANS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 W VAN BUREN ST STE 470
Mailing Address - Street 2:DEPARTMENT OF PREVENTIVE MEDICINE, RUSH UNIVERSITY
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3291
Mailing Address - Country:US
Mailing Address - Phone:312-942-3477
Mailing Address - Fax:312-942-8119
Practice Address - Street 1:1700 W VAN BUREN ST STE 470
Practice Address - Street 2:RUSH UNIVERSITY PREVENTION CENTER
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3291
Practice Address - Country:US
Practice Address - Phone:312-942-3133
Practice Address - Fax:312-942-8119
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071007986103TC0700X
AZ4051103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical