Brodech Medical Associates, SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

BRODECH MEDICAL ASSOCIATES, SC

Practice address

809 N Western Ave
Chicago, IL 60622-4637

Phone

(773) 772-9121

Fax

(773) 772-3939

NPI assigned

Apr 4, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Walter Brodech, M.D.

Title

President

Phone

(773) 772-9121

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023130507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 N WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224637",
            "telephone_number": "773-772-9121",
            "fax_number": "773-772-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 N WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224637",
            "telephone_number": "773-772-9121",
            "fax_number": "773-772-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRODECH MEDICAL ASSOCIATES, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRODECH",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-772-9121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0001618699",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meagan Nicole Brockman, MD
• Jennifer Marie Brockmeyer, MD
• Maureen Elizabeth Brocks-Hussain, APN
• Carol Brod
• Nadine Brodala, DDS, MS, DMD
• Eileen Margaret Brodecki, MOT, OTR/L
• Taylor Jo Broder, MD
• Bridget Broderick, SLP
• Byron Broderick, PTA
• Caitlin Broderick, MT-BC

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.