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:
Health care specialties
| Specialty | Code | License # | 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 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164696464 | NPPES |
| Illinois | Other | 2221474 | BCBS |
| Illinois | Other | 9919630 | BCBS |
| Illinois | MEDICAID | 1164696464-1 | BCBS |
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