Individual
MATT BRODIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
5381 BURR OAK RD, LISLE, IL 60532-2107
(618) 806-4264
Mailing address
5381 BURR OAK RD, LISLE, IL 60532-2107
(618) 806-4264
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
096003519
IL
Other
Enumeration date
11/13/2014
Last updated
11/13/2014
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