MR. BRADLEY GROLEAU NPI 1689025405

NPI Information

  • NPI: 1689025405
  • Provider Name: MR. BRADLEY GROLEAU
  • Classification: Student in an Organized Health Care Education/Training Program - 390200000X
  • Entity Type: Individual
  • Address: 2995 CARRIE ST
    PERU, IL
    ZIP 61354
  • Phone: (815) 830-7934

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NPI Details

MR. Bradley Groleau is a student in an organized health care education training program in Peru, IL. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. MR. Bradley Groleau NPI is 1689025405. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2995 CARRIE ST
PERU, IL
ZIP 61354-387
Phone: (815) 830-7934

The enumeration date for this NPI number is 6/22/2016 and was last updated on 6/22/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1390200000XStudent in an Organized Health Care Education/Training ProgramYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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