MATT BRODIE ATC NPI 1336545656

NPI Information

NPI: 1336545656
Provider Name: MATT BRODIE, ATC
Classification: Specialist/Technologist, Other - 246Z00000X
Entity Type: Individual
Address:
5381 BURR OAK RD
LISLE, IL
ZIP 60532
Phone: (618) 806-4264
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Matt Brodie, ATC is a specialist technologist other in Lisle, IL. The provider is general classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. Matt Brodie, ATC NPI is 1336545656. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5381 BURR OAK RD
LISLE, IL
ZIP 60532-107
Phone: (618) 806-4264

The enumeration date for this NPI number is 11/13/2014 and was last updated on 11/13/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	246Z00000X	Specialist/Technologist, Other		096003519	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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