Mrs Kelly R Broderick, LPC is a
Developmental Therapist based in La Grange, Illinois. Mrs Kelly R Broderick is licensed to practice in Illinois (license number ) and her current practice location is
515 S Ashland Ave, La Grange, Illinois. She can be reached at her office (for appointments etc.) via phone at
(708) 352-1880.
NPI number for Mrs Kelly R Broderick is 1881817443 and her current mailing address is 515 S Ashland Ave, La Grange, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1881817443.
Healthcare Provider's Profile
Full Name | Mrs Kelly R Broderick |
---|
Gender | Female |
---|
Speciality | Developmental Therapist |
---|
Location | 515 S Ashland Ave, La Grange, Illinois |
---|
Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1881817443
- Provider Enumeration Date: 04/11/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mrs Kelly R Broderick such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1881817443 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101Y00000X | Counselor | (Illinois) | Primary |
222Q00000X | Developmental Therapist | (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Kelly R Broderick is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Kelly R Broderick, LPC 515 S Ashland Ave, La Grange, IL 60525-2812 Ph: (708) 352-1880 | Mrs Kelly R Broderick, LPC 515 S Ashland Ave, La Grange, IL 60525-2812 Ph: (708) 352-1880 |
Reviews and Comments