Bo Xu, C.M.D.

Primary specialty

NutritionistTaxonomy code 133N00000X

License

55343813 Issued in IL

Practice address

1307 Bluejay LN
Plainfield, IL 60586-5423

Phone

(815) 685-6497

Fax

(815) 230-1851

NPI assigned

May 11, 2006

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

Other names 1

• Dr. Bob Xu Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• American Chinese Medicine Association Acma Inc

  • Nutritionist
  • Plainfield, IL
  • NPI 1346585239
  NPD (past) Authorized official

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447286400000",
    "number": "1629028626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 BLUEJAY LN",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605865423",
            "telephone_number": "815-685-6497",
            "fax_number": "815-230-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 BLUEJAY LN",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605865423",
            "telephone_number": "815-685-6497",
            "fax_number": "815-230-1851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XU",
        "first_name": "BO",
        "name_prefix": "Dr.",
        "credential": "C.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2015-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "IL",
            "license": "55343813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BOB",
            "last_name": "XU",
            "prefix": "DR.",
            "credential": "C.M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kimberly Wright
• William Everett Wright, D.C.
• Phoebe Wu, OTD, OTR/L
• Kathryn Wunsch
• Robert Wysocki, PSY.D.
• Yaden, Inc.
• Yarshen Family Medicine SC
• Jennifer Yoon
• Justin Christopher Young
• Nicholas Young, MS

• Nutritionist in Plainfield, IL
• Providers in Plainfield, IL by specialty
• Nutritionist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.

Verify at the official NPI Registry.