Individual
DR. CHERYL L BRODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
17850 KEDZIE AVE STE 3250, HAZEL CREST, IL 60429-2082
(708) 799-8700
(708) 957-1830
Mailing address
17850 KEDZIE AVE STE 3250, HAZEL CREST, IL 60429-2082
(708) 799-8700
(708) 957-1830
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036-090559
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036090559
—
IL
01
—
060053885
PALMETTO GBA INDIVIDUAL #
IL
01
—
21622931
BCBS GROUP #
IL
01
—
CI8250
PALMETTO GBA GROUP #
IL
Enumeration date
08/26/2005
Last updated
12/22/2021
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