Organization
SURGICAL NEUROLOGY ASSOC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD W BRODERICK M.D. (PRESIDENT)
(847) 398-6464
Entity
Organization
Contact information
Practice address
880 W CENTRAL RD, SUITE 6100, ARLINGTON HEIGHTS, IL 60005-2355
(847) 398-6464
(847) 398-7961
Mailing address
880 W CENTRAL RD, SUITE 6100, ARLINGTON HEIGHTS, IL 60005-2355
(847) 398-6464
(847) 398-7961
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
42002512
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1615968
BCBS IL
IL
Enumeration date
10/24/2006
Last updated
08/14/2013
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