BRADLEY LANE ASHPOLE, M.D. — NPI 1457516866 (Licensed & Credentialed Allopathic & Osteopathic Physicians

CMS-1500 Box 24J / 33a • NPI

1457516866

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

208200000X (CMS 02)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Plastic Surgery

Box 32 Service Location & ZIP+4

1107 N PROSPECT AVE, ITASCA, IL, 60143-1408

✓ 9-Digit EDI 837 ZIP+4 (60143-1408)

Practice Phone & Referral Fax

(847) 884-8346

Fax: (847) 739-0969

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1457516866 (BRADLEY LANE ASHPOLE, M.D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1457516866` (NPI-1 Individual Practitioner)
Provider / Legal Name	BRADLEY LANE ASHPOLE, M.D.
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Plastic Surgery NUCC Code: `208200000X` (Plastic Surgery)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1107 N PROSPECT AVE, ITASCA, IL, 60143-1408
Practice Telephone / Fax	Tel: (847) 884-8346 \| Fax: (847) 739-0969
Administrative Mailing Address	1333 W ESTATE LN E, LAKE FOREST, IL, 60045-3623
Enumeration & Last Sync	Enumerated: 2008-07-24 \| CMS Record Updated: 2024-05-10

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1107 N PROSPECT AVE, ITASCA, IL, 60143-1408

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Plain-English Taxonomy & CMS Crosswalk (208200000X)

What Does Taxonomy Code 208200000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208200000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Plastic Surgery"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 02 (Physician/General Surgery) • CMS Code 24 (Physician/Plastic and Reconstructive Surgery)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Plastic Surgery for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (BRADLEY LANE ASHPOLE, M.D.)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`208200000X` — Plastic Surgery Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Plastic Surgery	State: IL \| License: `036113854` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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BRADLEY LANE ASHPOLE, M.D. (NPI #1457516866)