Broderick, Kelly R.

Broderick, Kelly R. is an sole proprietor health care provider with primary practice located at 515 S Ashland Ave , La Grange IL 60525-2812. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Broderick, Kelly R. can be contacted via phone (708) 352-1880.

Contact Information

Primary practice address
515 S Ashland Ave La Grange IL 60525-2812
Phone: (708) 352-1880
Fax: (708) 352-1880
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X Illinois
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X Illinois

Profile Details

NPI number 1881817443
LBN Legal business name Broderick, Kelly R.
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 11th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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