Philip Charles Bodenstab Jr., MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Practice address

1044 N Francisco Avenue
Norwegian American Hospital
Chicago, IL 60622

Phone

(773) 278-8800

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245262401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 N STEWART AVE",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "60148",
            "telephone_number": "630-611-8029",
            "fax_number": "630-691-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 N FRANCISCO AVENUE",
            "address_2": "NORWEGIAN AMERICAN HOSPITAL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60622",
            "telephone_number": "773-278-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODENSTAB",
        "first_name": "PHILIP",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G21779",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME63662",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD00015200",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Boddu, MD
• Yamini Boddu, NP
• Ortensia Bode
• Taylor Boden, MMS, RD, PA-C
• Trista Ann Boden
• Anne Bodenstine, PT
• Alaya Bodepudi, MD
• Matthew Ryan Bodett
• Bodhi & Sage, LLC
• Bodhi & Sage, LLC

• Anesthesiology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Anesthesiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.