Kelly R. Broderick, L.P.C.

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

515 S Ashland Ave
La Grange, IL 60525-2812

Phone

(708) 352-1880

Fax

(708) 352-1880

NPI assigned

Apr 11, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1881817443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 S ASHLAND AVE",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605252812",
            "telephone_number": "708-352-1880",
            "fax_number": "708-352-1880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 S ASHLAND AVE",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605252812",
            "telephone_number": "708-352-1880",
            "fax_number": "708-352-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODERICK",
        "first_name": "KELLY",
        "middle_name": "R.",
        "name_prefix": "Mrs.",
        "credential": "L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Claire Brennan
• Jennifer Brennan
• Brionna Breznai, MOT, OTR/L
• Brian Drelicharz, LCSW, LLC
• Eunice Brobby, MD
• Carolyn Anne Bronke Wind, D.D.S.
• Jessica M Brown
• Sheila Bryck
• Carolyn Joan Buchanan, CCC SLP
• Cheryl Buhrke, MACCCSLP

• Counselor in La Grange, IL
• Providers in La Grange, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.