Stephen William Boudro, D.C.

Primary specialty

Internist ChiropractorTaxonomy code 111NI0900X

Practice address

287 W Butterfield Rd
Elmhurst, IL 60126-5037

Phone

(630) 617-5444

NPI assigned

Aug 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992717565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 W BUTTERFIELD RD",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265037",
            "telephone_number": "630-617-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 W BUTTERFIELD RD",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265037",
            "telephone_number": "630-617-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDRO",
        "first_name": "STEPHEN",
        "middle_name": "WILLIAM",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NI0900X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Internist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0001682440",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Djordje Boskov, M.D.
• Tanja S Boskov, MD
• Barbara Jane Bosslet, MA CCC-SLP/L
• Tessa Botka
• Corina Bottcher
• Meghan Bounsay
• Anil K. Bouri Jr., D.D.S., M.S.D.
• Nicholas John Bournazos, D.C.
• Christopher A Boutin, MD
• Ruth Bowhay, LCSW

• Internist Chiropractor in Elmhurst, IL
• Providers in Elmhurst, IL by specialty
• Internist Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.