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

Haley Rose Radev

Individual provider Physician Assistant · NPI 1801752209

Haley Rose Radev is a Physician Assistant in Bourbonnais, Illinois. Qualified in 2025, 1 year ago. Licensed in Illinois.

Years since qualifying
1
Licensed in
IL
In the registry since
2025

Practice location Address checks out

300 Riverside Dr Ste 2700
Bourbonnais, IL 60914-5071
Phone: (779) 701-2762
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085011853 (IL)

Record details

NPI number1801752209
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 29, 2025
Last updated in NPPESMarch 20, 2026
Certification dateMarch 20, 2026
Mailing address350 N Wall St, Kankakee, IL 60901-2901

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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