DR. GAY WINIFRED BRODERSEN (NPI# 1972766798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972766798 |
| Entity Type | Individual |
| Full Name | DR. GAY WINIFRED BRODERSEN |
| Credential | D.D.S. |
| Practice Address |
1880 N Roselle Rd Ste.212 Schaumburg IL 60195-3197 |
| Mailing Address |
212 N Grant St Hinsdale IL 60521-3336 |
| Practice Telephone | 8478823360 |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2008-09-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 019.023646 | IL | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
021.001749 | IL | Dental Providers |
| Street Address |
1880 N ROSELLE RD STE.212 |
| City | SCHAUMBURG |
| State | IL |
| Zip Code | 60195-3197 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508894205 | Naveed Elahi | Chiropractor | 1880 N Roselle Rd, 208, Schaumburg, IL 60195-3197 | 2006-06-29 |
| 1750643268 | Joseph W Mitchell Jr. Dds | Dentist | 1880 N Roselle Rd, Suite 201, Schaumburg, IL 60195-3197 | 2012-06-11 |
| 1750697942 | Danielle Bauer | Dentist | 1880 N Roselle Rd, Suite 212, Schaumburg, IL 60195-3197 | 2010-08-25 |
| 1952564585 | Nicola C Hill-cordell | Dentist | 1880 N Roselle Rd, Suite 212, Schaumburg, IL 60195-3197 | 2008-07-03 |
| 1235392986 | John S. Cordell | Dentist | 1880 N Roselle Rd, Ste. 212, Schaumburg, IL 60195-3197 | 2008-07-02 |
| 1154522753 | Asunta T. Moduthagam | Family Medicine | 1880 N Roselle Rd, Suite 208, Schaumburg, IL 60195-3197 | 2007-05-30 |
| 1528104296 | Joseph William Mitchell Jr. | Dentist | 1880 N Roselle Rd, Suite 201, Schaumburg, IL 60195-3197 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730606542 | Alexis V Anderson | Physical Therapist | 929 West Higgins Road, Schaumburg, IL 60195 | 2017-08-23 |
| 1710426796 | Wellness Institute of Illinois, Ltd | Non-Pharmacy Dispensing Site | 110 Hillcrest Blvd Suite 102, Schaumburg, IL 60195 | 2017-02-23 |
| 1891233318 | Malek Korkis | Dentist | 501 W Golf Rd Ste B, Schaumburg, IL 60195 | 2017-02-03 |
| 1841530334 | Yuhang Shek Md Sc | Clinic/Center | 110 Hillcrest Blvd, Suite 107, Schaumburg, IL 60195 | 2013-02-21 |
| 1730479841 | Karen Ednalino Smith | Physical Therapist | 929 West Higgins Road, Barrington Orthopedic Specialists, Ltd., Schaumburg, IL 60195 | 2011-04-10 |
| 1790089456 | Vishva Manmathdev Desai | Chiropractor | 80 West Hillcrest Blvd, Suite 208, Schaumburg, IL 60195 | 2011-01-10 |
| 1003119611 | Michael T Green | Dentist | 1900 N. Roselle Rd, #401, Schaumburg, IL 60195 | 2010-12-21 |
| 1346574381 | Kenneth Craig Chessick | Surgery | 1870 N. Roselle Road, Suite 104, Schaumburg, IL 60195 | 2009-09-23 |
| 1750413019 | Medcoa Physical Therapy | Physical Therapist | 1083 N Selem Dr, Schaumburg, IL 60195 | 2007-03-12 |
| 1164564019 | Jeffrey B Johnson | Specialist | 1555 N Barrington Road #410, Hoffman Estates, IL 60195 | 2007-02-13 |
| Find all providers in zip 60195 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821583634 | Dentalgenix | Dentist | 113 E Schaumburg Rd, Schaumburg, IL 60194-3518 | 2018-06-25 |
| 1194206052 | Abc Dentistry, LLP | Dentist | 80 W Hillcrest Blvd Ste 212, Schaumburg, IL 60195-3111 | 2018-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932709433 | Children's Center for Dentistry | Dentist | 314 Susan Dr, Normal, IL 61761-6206 | 2020-10-26 |
| 1073125746 | Jessica Mattern Dds, Pllc | Dentist | 326 W Burlington Ave, La Grange, IL 60525-2363 | 2020-08-23 |
| 1568925014 | Southern Illinois Pediatric Dentistry of Edwardsville | Dentist | 1419 Lewis Road, Suite 2, Edwardsville, IL 62025 | 2019-04-11 |
| 1710450754 | Drs Selberg & Rice Pllc | Dentist | 4945 Stone Falls Ctr Ste B, O Fallon, IL 62269-7801 | 2019-01-02 |
| 1528562253 | Rachel Vorwaller | Dentist | 1460 N Halsted St Ste 403, Chicago, IL 60642-2607 | 2018-03-19 |
| 1942740006 | Dhwani M. Joshi | Dentist | 195 S Rand Rd Ste 110, Lake Zurich, IL 60047-2205 | 2017-03-08 |
| 1316393390 | Erin Marie Petrik | Dentist | 2530 N Clark St, Apt 203, Chicago, IL 60614-4972 | 2016-05-10 |
| 1669839593 | Algonquin Kids Dentistry, Inc | Dentist | 4097 W Algonquin Rd, Algonquin, IL 60102-9401 | 2016-01-22 |
| 1720468598 | Mehedia Haque | Dentist | 2062 N Milwaukee Ave, Chicago, IL 60647 | 2015-06-05 |
| 1851788913 | Jaime Ann Chowaniec | Dentist | 45 S Park Blvd Ste 105, Glen Ellyn, IL 60137-6299 | 2015-04-16 |
| Find all providers with the same taxonomy | ||||
| City | SCHAUMBURG |
| Zip Code | 60195 |
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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.