Broderick, William Robert

Broderick, William Robert is an individual health care provider with primary practice located at 120 Spalding Drive Ste 111, Naperville IL 60540-6766. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Broderick, William Robert can be contacted via phone (630) 527-3788.

Contact Information

Primary practice address
120 Spalding Drive Ste 111 Naperville IL 60540-6766
Phone: (630) 527-3788
Fax: (630) 646-6071
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 036-115537 Illinois

Profile Details

NPI number 1164696464
LBN Legal business name Broderick, William Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 17th, 2008
Last updated Apr 2nd, 2013 - about 12 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 1164696464 NPPES
Illinois Other 2221474 BCBS
Illinois Other 9919630 BCBS
Illinois MEDICAID 1164696464-1 BCBS

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