Ronald G Bosh, MD
Individual provider Active NPI Internal Medicine Physician · Batavia, IL
NPI 1811928443 · NPPES record last updated Feb 16, 2017
Key facts
- NPI
- 1811928443
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 36060847 (IL)
- Practice address
- 2500 W Fabyan Pkwy
Batavia, IL 60510-1572 - Phone
- (630) 879-2110
- NPI assigned
- Jul 5, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36060847 | IL | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 36060847 | IL | Yes |
Addresses
Primary practice location
2500 W Fabyan Pkwy
Batavia, IL 60510-1572
Mailing address
2357 Sequoia Dr
Aurora, IL 60506-6222
Phone (630) 859-6800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36060847 | Other | IL | LICENSE |
| 036060847 | Medicaid | IL | |
| L01510 | Other | INDIVIDUAL MEDICARE # |
Other providers in Batavia, IL
- Joshua Jay Bletzinger
- Adam N Blonsky
- Blue Heron Counseling and Assessment
- Rochelle Lilian Borkhovik
- Simona Claire Borkhovik
- Jane M Boss
- Stephanie Lynn Bowen
- Karimah Eshe Boyce
- Joseph John Brandonisio
- Philip Branshaw
All providers in Batavia, IL · Internal Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.