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Active NPI 1578005955 Individual Practitioner Female Practitioner

Gwendolyn Bradley

Licensed Practical Nurse • O Fallon, IL

Professional Overview & Biography Verified Profile Summary

Gwendolyn Bradley is a registered healthcare professional specializing in Licensed Practical Nurse in O Fallon, IL. Practice services are available at 294 KINGS RIDGE BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

294 Kings Ridge Blvd

O Fallon, IL 622696330

Telephone 6189753781

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in O Fallon, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
3 Specialists

Practicing in O Fallon, IL (906 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License IL 043049025

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Cheryl Timmermann

Registered Nurse

NPI 1285184952
Victoria Monken

Technician - Personal Care Attendant

NPI 1407424559
Danielle Mueller

Licensed Practical Nurse

NPI 1528505146
Michelle Monken

Home Health Aide

NPI 1588230635
Angela Dillick

Nurse's Aide

NPI 1609344423

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active November 16, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location November 16, 2016

Registered at 294 KINGS RIDGE BLVD, O FALLON, IL 622696330 (Tel: 6189753781)

📍
Updated Business Mailing Address November 16, 2016

Registered at 1811 SAN RICARDO DR, SAINT LOUIS, MO 631381942 (Tel: 3143064934)

👤
Provider Name / Credentials Updated November 16, 2016

Recorded as GWENDOLYN BRADLEY

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 16, 2016

Licensed Practical Nurse (License #043049025 in IL)

🟢
Initial NPI Registration & Enumeration November 16, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1578005955
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 16, 2016
Last Update: November 16, 2016
Sole Proprietor: No

Mailing Address

1811 San Ricardo Dr

Saint Louis, MO 631381942

Phone: 3143064934

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.