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

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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