Peter W. Broido, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036042407 Issued in IL

Practice address

333 N. Canal Street
Unit 3504
Chicago, IL 60606-1543

Phone

(312) 575-8512

Fax

(312) 575-8513

NPI assigned

Aug 4, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217808000000",
    "number": "1740446277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N. CANAL STREET",
            "address_2": "UNIT 3504",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061543",
            "telephone_number": "312-575-8512",
            "fax_number": "312-575-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N. CANAL STREET",
            "address_2": "UNIT 3504",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061543",
            "telephone_number": "312-575-8512",
            "fax_number": "312-575-8513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROIDO",
        "first_name": "PETER",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-04",
        "last_updated": "2008-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036042407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veronica Ashley Broederdorf, OTR/L
• David Brogan, MD
• Jamie Thale Brogan, APN
• Joan Brogdon, LCSW
• Najeebullah Brohi, MD
• Amy Broitman, LCSW
• Kate Nora Broitman
• Crista Lynn Brokamp, APRN, CNP
• Carol Jean Bromberek, PT
• David Jeremy Bromberg, M.D.

• Surgery Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; 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.