Individual provider Active NPI

Clara Marie Bosco, MD

  • Surgery Physician
  • Chicago, IL
National Provider Identifier
1578205456
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
125.086862 Issued in IL
Practice address
251 E Huron St
Chicago, IL 60611-2908
Phone
(602) 839-2000
NPI assigned
Apr 11, 2022
Last updated
Mar 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 125.086862 IL Primary

Addresses

Primary practice location

251 E Huron St
Chicago, IL 60611-2908

Mailing address

4231 Willow Brook Rd
De Pere, WI 54115-9232
Phone (920) 857-0197

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://www.google.com/search?q=banner+university+medical+center&oq=Banner+&aqs=chrome.2.69i57j69i59j35i39j0i433i512l2j69i60l3.4491j0j7&sourceid=chrome&ie=UTF-8

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220630000435 AZ Order and Referring Only - General SurgeryPractitioner - General Surgery 4880074392

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125.086862ILMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1578205456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4231 WILLOW BROOK RD",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159232",
            "telephone_number": "920-857-0197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E HURON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "602-839-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSCO",
        "first_name": "CLARA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-11",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "125.086862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.google.com/search?q=banner+university+medical+center&oq=Banner+&aqs=chrome.2.69i57j69i59j35i39j0i433i512l2j69i60l3.4491j0j7&sourceid=chrome&ie=UTF-8",
            "affiliation": "N",
            "address_1": "1111 E McDowell Rd",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850062612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.