DR. RICHARD WILLIAM BRODERICK (NPI# 1285718833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285718833 |
| Entity Type | Individual |
| Full Name | DR. RICHARD WILLIAM BRODERICK |
| Credential | M.D. |
| Practice Address |
650 S Randall Rd Algonquin IL 60102-5944 |
| Mailing Address |
Box 78534 Milwaukee WI 53278-8534 |
| Practice Telephone | 8153989491 |
| Practice Fax Number | 8153817498 |
| Mailing Telephone | 8153989491 |
| Mailing Fax Number | 8153817498 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-06-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207T00000X | Neurological Surgery | DR.0063270 | CO | Allopathic & Osteopathic Physicians |
| Y | 207T00000X | Neurological Surgery | 036099789 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 9000181241 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2222 N Nevada Ave Ste 5001, Colorado Springs, CO 809076865 | 7197763580 | 7197763599 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801098124 | Richard Arthur Broderick | Internal Medicine | 6355 Walker Ln Ste 500, Alexandria, VA 22310-3251 | 2007-05-31 |
| Street Address |
650 S RANDALL RD |
| City | ALGONQUIN |
| State | IL |
| Zip Code | 60102-5944 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255329249 | Shawn W Palmer | Orthopaedic Surgery | 650 S Randall Rd, Algonquin, IL 60102-5944 | 2005-10-12 |
| 1609481332 | Natasha Marie Vanderlinden | Physical Therapist | 650 S Randall Rd, Algonquin, IL 60102-5944 | 2020-09-10 |
| 1396363776 | Rebecca Nauman | Physical Therapist | 650 S Randall Rd, Algonquin, IL 60102-5944 | 2020-07-11 |
| 1477049070 | Rockford Orthopedic Associates, Ltd | Orthopaedic Surgery | 650 S Randall Rd, Algonquin, IL 60102-5944 | 2018-07-06 |
| 1700378809 | Megan D Oney | Physical Therapist | 650 S Randall Rd, Algonquin, IL 60102-5944 | 2018-06-04 |
| 1972056455 | Michael K. Finigan | Physician Assistant | 650 S Randall Rd, Algonquin, IL 60102-5944 | 2016-08-01 |
| 1801258629 | Nicholas Christopher Brissey | Podiatrist | 650 S Randall Rd, Algonquin, IL 60102 | 2016-03-22 |
| 1275990285 | Amanda Kroymann | Physician Assistant | 650 S Randall Rd, Algonquin, IL 60102-5944 | 2016-01-21 |
| 1346623832 | Margaret A Greene | Physical Therapist | 650 S Randall Rd, Algonquin, IL 60102-5944 | 2015-07-02 |
| 1023421484 | Rebekah Mcmillen | Occupational Therapist | 650 S Randall Rd, Algonquin, IL 60102-5944 | 2014-06-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700411329 | Amber Nicole Bianchi | Massage Therapist | 265 Stonegate Road, Algonquin, IL 60102 | 2020-03-04 |
| 1255971156 | Cler Family Solutions LLC | Case Management | 12 Waterfront Ct, Algonquin, IL 60102 | 2020-01-09 |
| 1114577079 | Camp Chirotherapy LLC | Chiropractor | 3925 W Algonquin Rd, Algonquin, ID 60102 | 2019-09-12 |
| 1295380392 | Kevin Layton Sanderson | In Home Supportive Care | 9604 Zimmer Drive, Algonquin, IL 60102 | 2019-08-06 |
| 1669964300 | Favia Primary Care, Sc | Family Medicine | 1340 Ryan Parkway, Algonquin, IL 60102 | 2018-05-30 |
| 1285142745 | Melissa Sue Aeschliman | Speech-Language Pathologist | 8 White Chapel Ct., Algonquin, IL 60102 | 2018-01-18 |
| 1295251940 | Maria Melina Dominguez | Counselor | 1138 N. Main Street, Algonquin, IL 60102 | 2017-08-15 |
| 1578001830 | Advanced Dental and Implant Care PC | Dentist | 2310 Huntington Dr. N., Algonquin, IL 60102 | 2017-02-07 |
| 1871037861 | Rehabcare Group East, LLC | Clinic/Center | 212 Eastgate Ct, Algonquin, IL 60102 | 2016-12-09 |
| 1891172664 | Foot and Ankle Specialists of Illinois Ltd | Podiatrist | 2430 Esplanade Drive Suite A, Algonquin, IL 60102 | 2015-04-30 |
| Find all providers in zip 60102 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871114371 | Justin Michael | Neurological Surgery | 701 N 1st St Ste D-319, Springfield, IL 62702-3757 | 2020-05-06 |
| 1023678638 | Matthew Weber | Neurological Surgery | 701 N 1st St, Suite D-319, Springfield, IL 61702 | 2019-06-17 |
| 1891281499 | Kamran Khan, Sc | Neurological Surgery | 1890 Silver Cross Blvd Ste 450, New Lenox, IL 60451-9518 | 2018-07-06 |
| 1881124030 | Denise Brunozzi | Neurological Surgery | 912 South Wood Street, 451 N - Hc 739, Chicago, IL 60612 | 2017-06-19 |
| 1407218365 | St Anthonys Physician Organization of Illinois | Neurological Surgery | 211 S Burns Ave, Sparta, IL 62286-1895 | 2016-03-22 |
| 1225455181 | Jehad Algharabli | Neurological Surgery | 2218 S Leavitt St, Chicago, IL 60608-4008 | 2014-03-27 |
| 1992041461 | Gursant Atwal | Neurological Surgery | University of Il Hospital & Health Science System, 1740 W Taylor St, Chicago, IL 60612 | 2013-01-02 |
| 1629321112 | James Bruce Mansfield | Neurological Surgery | 5 Loch Ln, South Barrington, IL 60010-9532 | 2012-10-21 |
| 1639445877 | Joseph R Rivas | Neurological Surgery | 511 W Belmont Ave, #32, Chicago, IL 60657-4663 | 2012-03-30 |
| 1356637722 | Melissa M Stamates | Neurological Surgery | 2650 Ridge Ave Fl 3, Evanston, IL 60201 | 2011-06-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.