Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bradly Miner

Individual provider Physician Assistant · NPI 1104434240

Bradly Miner is a Physician Assistant in Chicago, Illinois. Qualified in 2021, 5 years ago. Practices with Northwestern Medical Faculty Foundation, a 4,394-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
5
Licensed in
IL
In the registry since
2020
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Practice location Address checks out

675 N Saint Clair St Ste 18-250
Chicago, IL 60611-5980
Phone: (312) 695-1800
Fax: (312) 695-4741
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085008637 (IL)

Record details

NPI number1104434240
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 15, 2020
Last updated in NPPESJanuary 17, 2022
Certification dateJanuary 17, 2022
Mailing address675 N Saint Clair St Ste 18-250, Chicago, IL 60611-5980

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Northwestern Medical Faculty Foundation — 4394 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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