Organization
BROADWAY ORTHOPEDICS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALFRED A AKKERON MD (PRESIDENT)
(708) 344-0870
Entity
Organization
Contact information
Practice address
1111 SUPERIOR ST, SUITE 305, MELROSE PARK, IL 60160-4138
(708) 344-0870
(708) 343-4490
Mailing address
1111SUPERIOR STREET, SUITE 305, MELROSE PARK, IL 60160-4158
(708) 344-0870
(708) 343-4490
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036042498
—
IL
01
—
1306880919
PROVIDER NPI
—
01
—
21604940
BLUE CROSS BLUE SHIELD
—
Enumeration date
03/27/2008
Last updated
05/01/2008
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