Broderick, Richard William

Broderick, Richard William is an individual health care provider with primary practice located at 1435 N Randall Rd Ste 107 , Elgin IL 60123-2302. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Broderick, Richard William can be contacted via phone (224) 359-0130.

Contact Information

Primary practice address
1435 N Randall Rd Ste 107 Elgin IL 60123-2302
Phone: (224) 359-0130
Fax: (224) 359-0129
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X DR.0063270 Colorado
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 036099789 Illinois

Profile Details

NPI number 1285718833
LBN Legal business name Broderick, Richard William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2006
Last updated Dec 17th, 2021 - about 4 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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Identifiers

StateTypeNumberIssuer
All States NPI 1285718833 NPPES
Colorado MEDICAID 9000181241

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