Maria B Broadstreet, CPNP
Nurse Practitioner in Oak Lawn, IL. Individual provider (NPI-1).
NPI number1316978992
StatusActive
Last updated in NPPESJun 18, 2025
Details
- NPI
- 1316978992
- Entity type
- Individual (NPI-1)
- Name
- Ms. Maria B Broadstreet
- Credential
- CPNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 5, 2006
- Certification date
- Jun 18, 2025
- Last updated
- Jun 18, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 209004364 | IL | Yes |
| 363LP0200X | Nurse Practitioner, Pediatrics | 209004364 | IL |
Practice location
4400 W 95th St Ste 106Oak Lawn, IL 60453-2656
Phone 708-684-5580 · Fax 708-684-4068
Mailing address
29373 Network PlChicago, IL 60673-3717
Phone 847-390-5900
Other practice locations
2300 N Childrens Plz
Chicago, IL 60614-3363
Chicago, IL 60614-3363
Phone 773-880-3681
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