Active NPI
John J Boeren, MD
- General Practice Physician
- Belleville, IL
National Provider Identifier
1376530949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Practice address
- 311 W Lincoln St
Suite 300
Belleville, IL 62220-1902 - Phone
- (618) 234-2566
- Fax
- (618) 234-5650
- NPI assigned
- Sep 29, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | IL | Primary |
Addresses
Primary practice location
311 W Lincoln St
Suite 300
Belleville, IL 62220-1902
Mailing address
311 W Lincoln St
Suite 300
Belleville, IL 62220-1902
Phone (618) 234-2566
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0150523 | Other | UNITED HEALTHCARE | |
| 08215273 | Other | BCBS IL | |
| 117951 | Other | HEALTHLINK | |
| 127868 | Other | BCBS MO | |
| 80015974 | Other | RR MEDICARE | |
| 166403 | Other | GROUP HEALTH PLAN | |
| 5648285 | Other | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- john.boeren.1@26900.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1376530949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 W LINCOLN ST",
"address_2": "SUITE 300",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622201902",
"telephone_number": "618-234-2566",
"fax_number": "618-234-5650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 W LINCOLN ST",
"address_2": "SUITE 300",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622201902",
"telephone_number": "618-234-2566",
"fax_number": "618-234-5650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOEREN",
"first_name": "JOHN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-29",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0150523",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS IL",
"identifier": "08215273",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "117951",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MO",
"identifier": "127868",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "80015974",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP HEALTH PLAN",
"identifier": "166403",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5648285",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.