Elyse J Boroski

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164007562 Issued in IL

Practice address

530 Park Ave E Ste 201
Princeton, IL 61356-2598

Phone

(815) 876-4447

NPI assigned

Dec 16, 2018

Last updated

Dec 16, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Elyse J Breuning Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hygienic Institute for Lasalle, Peru and Oglesby

  • Rural Health Clinic/Center
  • La Salle, IL
  • NPI 1912944703
  NPD

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1629549704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 PARK AVE E STE 201",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613562598",
            "telephone_number": "815-876-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 PARK AVE E STE 201",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613562598",
            "telephone_number": "815-876-4447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 West St",
            "address_purpose": "LOCATION",
            "city": "Peru",
            "state": "IL",
            "postal_code": "613542757",
            "country_code": "US",
            "telephone_number": "815-223-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOROSKI",
        "first_name": "ELYSE",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164007562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELYSE",
            "last_name": "BREUNING",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Marie Birkey, CNM, FNP-C, PMHNP-BC
• Christopher Thomas Blanford, M.D.
• BMP Tri Co Spec Educ Coop
• Bobrowski Industries Princeton LLC (Fawcetts Pharmacy)
• Paul H Bonucci, MD
• Shirley M Borys, LPC
• Bureau County Family Health
• Bureau County Family Health
• Bureau Valley Anesthesia Group, Inc.
• Diane Marie Carlone, PT

• Registered Dietitian in Princeton, IL
• Providers in Princeton, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; 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.