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Individual
AMY B BRODSKY
Active
Individual
AMY B BRODSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070012027
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619908
BCBS IL GROUP NUMBER
IL
01
—
1623066
BCBS PROVIDER #
IL
01
—
367885100
US DEPT OF LABOR
IL
01
—
568080
MEDICARE GROUP NUMBER
IL
01
—
CJ4383
R.R. MEDICARE GROUP#
IL
Enumeration date
04/04/2007
Last updated
09/03/2015
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