Individual
KATHLEEN BRODERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
11840 S WESTERN AVE, CHICAGO, IL 60643-4734
(773) 233-9000
Mailing address
11840 S WESTERN AVE, CHICAGO, IL 60643-4734
(773) 233-9000
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
198.000044
IL
Other
Enumeration date
04/30/2012
Last updated
04/30/2012
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