DR. JOHN J BOEREN (NPI# 1376530949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376530949 |
| Entity Type | Individual |
| Full Name | DR. JOHN J BOEREN |
| Credential | MD |
| Practice Address |
311 W Lincoln St Suite 300 Belleville IL 62220-1902 |
| Practice Telephone | 6182342566 |
| Practice Fax Number | 6182345650 |
| Mailing Telephone | 6182342566 |
| Mailing Fax Number | 6182345650 |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HEALTHLINK | 117951 | 01 | |
| GROUP HEALTH PLAN | 166403 | 01 | |
| BCBS IL | 08215273 | 01 | |
| RR MEDICARE | 80015974 | 01 | |
| AETNA | 5648285 | 01 | |
| UNITED HEALTHCARE | 0150523 | 01 | |
| BCBS MO | 127868 | 01 |
| Street Address |
311 W LINCOLN ST SUITE 300 |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62220-1902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770042111 | Ahmed 15 LLC | Clinic/Center | 311 W Lincoln St, Belleville, IL 62220-1902 | 2019-03-15 |
| 1467803049 | Mallory Ann Butler | Nurse Practitioner | 311 W Lincoln St, Suite 100, Belleville, IL 62220-1902 | 2016-06-24 |
| 1275933756 | Belleville Surgical Center Ltd | Clinic/Center | 311 W Lincoln St, Suite 300, Belleville, IL 62220-1902 | 2014-09-03 |
| 1356760946 | Metro East Anesthesia LLC | Nurse Anesthetist, Certified Registered | 311 W Lincoln St, Ste 101, Belleville, IL 62220-1902 | 2014-04-10 |
| 1700218146 | Belleville Endoscopy Anesthesia | Anesthesiology | 311 W Lincoln St, Suite 100, Belleville, IL 62220-1902 | 2013-08-08 |
| 1851735450 | Mark S. Feldman, M.d. P.C. | Specialist | 311 W Lincoln St, Suite 100, Belleville, IL 62220-1902 | 2013-04-25 |
| 1497026686 | Belleville Endoscopy | Specialist | 311 W Lincoln St, Suite 100, Belleville, IL 62220-1902 | 2012-01-19 |
| 1770893919 | Robert Hellman Md. LLC | Anesthesiology | 311 W Lincoln St, Suite 300, Belleville, IL 62220-1902 | 2010-10-20 |
| 1215198973 | Cheryl L Kulik | Nurse Anesthetist, Certified Registered | 311 W Lincoln St, Ste 101, Belleville, IL 62220-1902 | 2008-06-24 |
| 1821210287 | Walter R. Glauber | Registered Nurse | 311 W Lincoln St, Ste 201, Belleville, IL 62263-1902 | 2007-05-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144729716 | St. Elizabeth's Hospital of The Hospital Sisters of The Third Order Of | Clinic/Center | 180 South Third Street Suite 101, Belleville, IL 62220 | 2018-02-08 |
| 1437675535 | Prorehab PC | Occupational Therapist | 1915 Carlyle Ave, Ste D, Belleville, IL 62220 | 2017-08-21 |
| 1629527650 | Arika Forrest | Nurse Practitioner | 140 Iowa Ave, Belleville, IL 62220 | 2016-10-03 |
| 1861861403 | Belleville Endoscopy LLC | Internal Medicine | 311 West Lincoln St, Suite 101, Belleville, IL 62220 | 2015-09-24 |
| 1962871558 | Antony Frierdich | Specialist/Technologist | 22 South 13th Street, Belleville, IL 62220 | 2015-09-24 |
| 1588032858 | Dana Wright | Pharmacist | 211 South Thrid Street, Belleville, IL 62220 | 2015-09-03 |
| 1629208731 | Lisa Marlow Johnson | Developmental Therapist | 34 Fenwood Dr, Belleville, IL 62220 | 2009-07-23 |
| 1841361623 | Neurological Surgery of Belleville | Neurological Surgery | 340 West Lincoln Street, Suite 540, Belleville, IL 62220 | 2006-11-13 |
| 1689769119 | Kathy Jo Corn | Counselor | 521 W. Main, Suite 201 B, Belleville, IL 62220 | 2006-10-03 |
| 1780609578 | Southern Illinois Health Care Foundation, Inc. | Counselor | 180 S 3rd St Ste 103&104, Belleville, IL 62220 | 2006-07-13 |
| Find all providers in zip 62220 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861777690 | Carmicheal LLC | General Practice | 8601 West Main St., Ste. 101, Belleville, IL 62223 | 2011-10-12 |
| 1073522249 | Nai Hua Shu | General Practice | 1600 Lebanon Ave, Suite 101, Belleville, IL 62221-2491 | 2006-08-06 |
| 1184617086 | Glen S Babich | General Practice | 813 Stone Creek Ln, Belleville, IL 62223-2655 | 2005-08-25 |
| 1285634287 | Branch Brook Hospital Physicians, P.a. | General Practice | 1 Clara Maass Drive, Belleville, NJ 07109-3550 | 2005-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538775192 | Discover Integrated Medical Center, Ltd. | General Practice | 2207 N Us Highway 12 Ste E, Spring Grove, IL 60081-9706 | 2020-09-18 |
| 1154946903 | Wound Pros Illinois | General Practice | 5250 Old Orchard Rd., Suite 300, Skokie, IL 60077-4462 | 2020-06-08 |
| 1306465786 | Brightlife Regenerative Medical Clinic Lombard Sc | General Practice | 442 E Roosevelt Rd, Lombard, IL 60148-4630 | 2020-04-15 |
| 1851920524 | Sahens Mezidor | General Practice | 228 Ridge Ave Apt G, Evanston, IL 60202-6409 | 2020-04-05 |
| 1447881487 | Tyrian Healthcare Solutions, LLC | General Practice | 2120 W Heading Ave, West Peoria, IL 61604-5138 | 2020-01-29 |
| 1598302077 | Enhance Medical LLC | General Practice | 1193 N Gary Ave, Carol Stream, IL 60188-9423 | 2019-12-04 |
| 1164067054 | League Corp. | General Practice | 515 N State St Fl 8, Chicago, IL 60654-9102 | 2019-11-14 |
| 1679129977 | Chronic Care Solutions LLC | General Practice | 3050 W Columbia Ave, Chicago, IL 60645-4006 | 2019-08-13 |
| 1205393972 | Midwest Medical LLC | General Practice | 2001 Midwest Rd Ste Ll22, Oak Brook, IL 60523-1316 | 2019-02-28 |
| 1306311725 | Genesis Integrative Medicine LLC | General Practice | 1881 S Randall Rd Ste C, Geneva, IL 60134-2532 | 2018-10-11 |
| Find all providers with the same taxonomy | ||||
| City | BELLEVILLE |
| Zip Code | 62220 |
Please comment or provide details below to improve the information on DR. JOHN J BOEREN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.