Active NPI
Clara Marie Bosco, MD
- Surgery Physician
- Chicago, IL
National Provider Identifier
1578205456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 125.086862
- Practice address
- 251 E Huron St
Chicago, IL 60611-2908 - Phone
- (602) 839-2000
- NPI assigned
- Apr 11, 2022
- Last updated
- Mar 30, 2026
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220630000435 | AZ | Order and Referring Only - General Surgery | 4880074392 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.086862 | IL | MD | Surgery 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.