Broederdorf, Kelly M

Broederdorf, Kelly M is an individual health care provider with primary practice located at 3707 Doty Rd Ste Candd , Woodstock IL 60098-7530. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Oncology, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Broederdorf, Kelly M can be contacted via phone (815) 338-6600.

Contact Information

Primary practice address
3707 Doty Rd Ste Candd Woodstock IL 60098-7530
Phone: (815) 338-6600
Fax: (815) 206-1086
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Oncology 163WX0200X 041.387373 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209-027210 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209027210 Illinois

Profile Details

NPI number 1952023459
LBN Legal business name Broederdorf, Kelly M
Credentials REGISTERED NURSE
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2022
Last updated Jun 10th, 2024 - about 2 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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