Kyle Boudreau

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

250 S Northwest Hwy Ste 204
Park Ridge, IL 60068-4237

Phone

(773) 631-4112

Fax

(773) 594-2113

NPI assigned

Aug 21, 2026

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1787270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1306752969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S NORTHWEST HWY STE 200",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684252",
            "telephone_number": "847-324-3976",
            "fax_number": "847-929-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S NORTHWEST HWY STE 204",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684237",
            "telephone_number": "773-631-4112",
            "fax_number": "773-594-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAU",
        "first_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-21",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerry Mark Bornhoff, ATC, LAT, CSCS
• Marvin Michael Bornschlegl, LCPC
• Alissa Danielle Borowsky, MD
• Carly Ann Bosco
• Gianna Bosco, MD
• Kristine Bowersox, PA-C
• Elise Marie Bowler, DO
• Emily Elizabeth Bowman, M.S. CF-SLP
• Boyce Family Eye Care, LTD.
• Diane Kay Boyle, APN

• Physical Therapist in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2026; 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.