BROADWAY ORTHOPEDICS LTD (NPI# 1952573149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952573149 |
| Entity Type | Organization |
| Organization Name | BROADWAY ORTHOPEDICS LTD |
| Practice Address |
1111 Superior St Suite 305 Melrose Park IL 60160-4138 |
| Mailing Address |
1111superior Street Suite 305 Melrose Park IL 60160-4158 |
| Practice Telephone | 7083440870 |
| Practice Fax Number | 7083434490 |
| Mailing Telephone | 7083440870 |
| Mailing Fax Number | 7083434490 |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2008-05-01 |
| Authorized Official Name | DR. ALFRED A AKKERON (PRESIDENT) |
| Authorized Official Telephone | 7083440870 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036042498 | 05 | |
| BLUE CROSS BLUE SHIELD | 21604940 | 01 | |
| PROVIDER NPI | 1306880919 | 01 |
| Street Address |
1111 SUPERIOR ST SUITE 305 |
| City | MELROSE PARK |
| State | IL |
| Zip Code | 60160-4138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528069481 | Peter Evelio Eupierre | Internal Medicine | 1111 Superior St, Suite 408, Melrose Park, IL 60160-4138 | 2005-08-02 |
| 1063046019 | Ngr LLC | Clinic/Center | 1111 Superior St, Suite 304, Melrose Park, IL 60160-4156 | 2020-02-28 |
| 1528531902 | Pipeline Midwest Pharmacies, LLC | Pharmacy | 1111 Superior St, Melrose Park, IL 60160-4138 | 2019-01-08 |
| 1376903252 | Brian Patrick Ervin | Physical Therapist | 1111 Superior St, Outpatient Physical Therapy, Melrose Park, IL 60160-4138 | 2016-03-04 |
| 1700245982 | Midwest Nephrology & Internal Medicine Associates, Corp. | Internal Medicine | 1111 Superior St, Suite 204, Melrose Park, IL 60160-4156 | 2016-02-17 |
| 1790161289 | Malapati Inc | Internal Medicine | 1111 Superior St, Suite 410, Melrose Park, IL 60160-4138 | 2015-08-06 |
| 1568858223 | Kim Mccoy | Registered Nurse | 1111 Superior St, Suite 101, Melrose Park, IL 60160-4138 | 2015-04-09 |
| 1245636372 | Emily Casselbury | Nurse Practitioner | 1111 Superior St, Suite 104, Melrose Park, IL 60160-4138 | 2014-11-18 |
| 1437553013 | Sarah Grebasch | Social Worker | 1111 Superior St, Melrose Park, IL 60160-4138 | 2014-10-10 |
| 1902207004 | Bernie M. Aguilar | Registered Nurse | 1111 Superior St, Suite 101, Melrose Park, IL 60160-4138 | 2014-09-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295217651 | Kairsten Thies | Registered Nurse | 1225 W. Lake St., Melrose Park, IL 60160 | 2018-09-02 |
| 1780195701 | Julia Mccann-khludenev | Nurse Practitioner | 153 1/2 Broadway Ave., Melrose Park, IL 60160 | 2017-10-17 |
| 1629595749 | Katarzyna Teresa Buksa | Speech-Language Pathologist | 906 Walton St., Melrose Park, IL 60160 | 2017-08-29 |
| 1972955102 | Erika Lazaro | Counselor | 1414 Main Street, Melrose Park, IL 60160 | 2016-07-12 |
| 1811344096 | Margaret Ann Kress | Nurse Practitioner | 675 W North Ave Ste 402, Melrose Park, IL 60160 | 2016-05-18 |
| 1942578703 | Rachna Shah Md Sc | Internal Medicine | 675 West North Ave, #310, Melrose Park, IL 60160 | 2011-12-08 |
| 1033486741 | Stephanie Lamonica | Pharmacist | 850 West North Ave, T0837, Melrose Park, IL 60160 | 2011-11-23 |
| 1285913384 | Melinda Vazquez | Social Worker | 1414 Main, Melrose Park, IL 60160 | 2011-08-08 |
| 1629373212 | Advanced Wellness Clinics | Internal Medicine | 1835 N Broadway Avenue, Suite 104, Melrose Park, IL 60160 | 2011-01-13 |
| 1508188525 | Guillermo Fernando Mora | Family Medicine | 1111 W Superior, Suite #306, Melrose Park, IL 60160 | 2010-02-17 |
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| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124379045 | Henry M Holmes | Orthopaedic Surgery | 1700 Riverwoods Dr, #519, Melrose Park, IL 60160-1613 | 2012-10-02 |
| 1306880919 | Alfred A Akkeron | Orthopaedic Surgery | 1111 Superior, Suite 305, Melrose Park, IL 60160-2041 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144834680 | Illinois Bone and Joint Institute LLC | Orthopaedic Surgery | 1200 S York St Ste 4110, Elmhurst, IL 60126-5630 | 2020-09-02 |
| 1790303725 | Illinois Bone and Joint Institute LLC | Orthopaedic Surgery | 1009 Il Route 22 Ste 2, Fox River Grove, IL 60021-1998 | 2020-07-07 |
| 1104440049 | Elliot M Johns | Orthopaedic Surgery | 301 N 8th St Ste 3a158, Springfield, IL 62701-1085 | 2020-06-06 |
| 1740804764 | David Alan Forgas | Orthopaedic Surgery | 901 N 1st St # D252, Springfield, IL 62702-3759 | 2020-06-05 |
| 1700417185 | Illinois Bone and Joint Institute, LLC | Orthopaedic Surgery | 1890 Silver Cross Blvd # A, New Lenox, IL 60451-9524 | 2020-02-04 |
| 1588207799 | Illinois Bone and Joint Institute, LLC | Orthopaedic Surgery | 2719 W Algonquin Rd, Algonquin, IL 60102-9400 | 2019-10-21 |
| 1669020848 | Illinois Bone and Joint Institute, LLC | Orthopaedic Surgery | 406 Front St Ste 100, Mchenry, IL 60050-5593 | 2019-08-30 |
| 1790342194 | Kevin James Rasuli | Orthopaedic Surgery | 1611 W Harrison St. Ste. 400, Chicago, IL 60612 | 2019-05-22 |
| 1134680713 | Madeline Shaoyun Tiee | Orthopaedic Surgery | Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL 60153 | 2019-03-27 |
| 1538629746 | Michael Murphy | Orthopaedic Surgery | 2160 S 1st Ave., Maguire Center, Dept of Ortho Surg, Maywood, IL 60153 | 2019-03-22 |
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| City | MELROSE PARK |
| Zip Code | 60160 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.