Kelly M Broederdorf, REGISTERED NURSE - Medicare Nurse Practitioner in Lincolnshire, IL

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Kelly M Broederdorf, REGISTERED NURSE is a medicare enrolled "Nurse Practitioner - Family" in Lincolnshire, Illinois. Her current practice location is 100 Village Grn Ste 120, Lincolnshire, Illinois. You can reach out to her office (for appointments etc.) via phone at (847) 634-1766.

Kelly M Broederdorf is licensed to practice in Illinois (license number 209-027210) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1952023459.

Contact Information

Kelly M Broederdorf, REGISTERED NURSE
100 Village Grn Ste 120,
Lincolnshire, IL 60069-3095
(847) 634-1766
(847) 634-2894

Map and Direction




Provider's Profile

Full NameKelly M Broederdorf
GenderFemale
SpecialityNurse Practitioner - Family
Location100 Village Grn Ste 120, Lincolnshire, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1952023459
  • Provider Enumeration Date: 09/13/2022
  • Last Update Date: 04/24/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 7113382987
  • Enrollment ID: I20230501000491

Medical Identifiers

Medical identifiers for Kelly M Broederdorf such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1952023459NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 209-027210 (Illinois)Primary
163WX0200XRegistered Nurse - Oncology 041.387373 (Illinois)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kelly M Broederdorf allows following entities to bill medicare on her behalf.
Entity NameAdvocate Health And Hospitals Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1700824455
PECOS PAC ID: 7810800935
Enrollment ID: O20031106000064
Entity NameCentral Dupage Physician Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1033149844
PECOS PAC ID: 5890696231
Enrollment ID: O20040303000601

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly M Broederdorf is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kelly M Broederdorf, REGISTERED NURSE
29373 Network Pl,
Chicago, IL 60673-7005

Ph: (847) 390-5900		Kelly M Broederdorf, REGISTERED NURSE
100 Village Grn Ste 120,
Lincolnshire, IL 60069-3095

Ph: (847) 634-1766

Reviews and Comments


Nurse Practitioner Nurses in Lincolnshire, IL

Daryl Janczyk,
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 103 Schelter Rd Ste 30, Lincolnshire, IL 60069
Phone: 847-821-0074    
Kristin Ann Ostergaard, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 100 Village Grn Ste 120, Lincolnshire, IL 60069
Phone: 847-634-1766    Fax: 847-634-2894
Shaikh Nadeem,
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Practice Location: 250 Parkway Dr Ste 150, Lincolnshire, IL 60069
Phone: 415-671-2165    
Erika Murray, FNP-BC
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Practice Location: 185 Milwaukee Ave Ste 230, Lincolnshire, IL 60069
Phone: 847-883-0077    
Mrs. Gutjiera Rasin, FNP
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Medicare: Not Enrolled in Medicare
Practice Location: 18 Oxford Dr, Lincolnshire, IL 60069
Phone: 773-600-2190    
Mrs. Margaret Kettner Salas, FNP-C
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 103 Schelter Rd Ste 30, Lincolnshire, IL 60069
Phone: 847-821-0074    
Elizabeth A Kislov, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 207 Rivershire Ln Apt 206, Lincolnshire, IL 60069
Phone: 847-338-1321    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.