Active NPI
Laura A Bosken, DPT
- Physical Therapist
- Wheaton, IL
National Provider Identifier
1568745289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070-021340
- Practice address
- 1071 E Roosevelt Rd
Wheaton, IL 60187-6609 - Phone
- (630) 682-1785
- NPI assigned
- Sep 20, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-013617 | OH | |
| Physical Therapist | 225100000X | 070-021340 | IL | Primary |
Addresses
Primary practice location
1071 E Roosevelt Rd
Wheaton, IL 60187-6609
Mailing address
1071 E Roosevelt Rd
Wheaton, IL 60187-6609
Phone (630) 682-1785
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-013617 | OH | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Powers Professional Corporation | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Parma, OH
- NPI 1588772925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436832000000",
"number": "1568745289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1071 E ROOSEVELT RD",
"city": "WHEATON",
"state": "IL",
"postal_code": "601876609",
"telephone_number": "630-682-1785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1071 E ROOSEVELT RD",
"city": "WHEATON",
"state": "IL",
"postal_code": "601876609",
"telephone_number": "630-682-1785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSKEN",
"first_name": "LAURA",
"middle_name": "A",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-20",
"last_updated": "2015-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT-013617",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-021340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wheaton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.