Provider Demographics
NPI:1902217938
Name:BRADY, ALEXANDRA KOHL (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:KOHL
Last Name:BRADY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 W END CT STE 500
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1379
Mailing Address - Country:US
Mailing Address - Phone:847-522-8900
Mailing Address - Fax:847-680-6177
Practice Address - Street 1:830 W END CT STE 500
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061
Practice Address - Country:US
Practice Address - Phone:847-522-8900
Practice Address - Fax:847-680-6177
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-13
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036142990208000000X
IL036.142990208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty