Broderick, Colin Michael

Broderick, Colin Michael is an individual health care provider with primary practice located at 5875 E Riverside Blvd , Rockford IL 61114-4937. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Broderick, Colin Michael can be contacted via phone (815) 398-9491.

Contact Information

Primary practice address
5875 E Riverside Blvd Rockford IL 61114-4937
Phone: (815) 398-9491
Fax: (815) 381-7498
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085-008977 Illinois

Profile Details

NPI number 1982089066
LBN Legal business name Broderick, Colin Michael
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 30th, 2015
Last updated May 18th, 2023 - about 3 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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