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DR. WILLIAM ROBERT BRODERICK M.D. NPI 1164696464


NPI Information

NPI: 1164696464
Provider Name: DR. WILLIAM ROBERT BRODERICK, M.D.
Classification: Internal Medicine - 207RH0003X
Entity Type: Individual

Specialization: Hematology & Oncology

Organization: EDWARD HEALTH VENTURES

PECOS Registration: Yes

Address:
120 SPALDING DRIVE
STE 111
NAPERVILLE, IL
ZIP 60540
Phone: (630) 527-3788
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DR. William Robert Broderick, M.D. is a hematology and oncology internal medicine in Naperville, IL with 25 years of experience. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. DR. William Robert Broderick, M.D. NPI is 1164696464. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
Graduation Year:1999

The provider's business location address is:

120 SPALDING DRIVE
STE 111
NAPERVILLE, IL
ZIP 60540-766
Phone: (630) 527-3788
Fax: (630) 646-6071

The NPI 1164696464 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/17/2008 and was last updated on 4/2/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RH0003XInternal MedicineHematology & Oncology036-115537ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12221474OTHERILLINOISBCBS
2P00775241MEDICARE PINILLINOIS
3215010012MEDICARE PINILLINOIS
41164696464-1MEDICAIDILLINOIS
5399180002MEDICARE PINILLINOIS
69919630OTHERILLINOISBCBS
7366700004MEDICARE PINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.