THERESE MARIE BOLGER P.A. NPI 1871867374

NPI Information

NPI: 1871867374
Provider Name: THERESE MARIE BOLGER, P.A.
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
4255 W 63RD ST
CHICAGO, IL
ZIP 60629
Phone: (773) 424-4048
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Therese Marie Bolger, P.A. is a medical physician assistant in Chicago, IL. Therese Marie Bolger, P.A. NPI is 1871867374. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4255 W 63RD ST
CHICAGO, IL
ZIP 60629-041
Phone: (773) 424-4048
Fax: (773) 424-6463

The NPI 1871867374 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/1/2012 and was last updated on 5/7/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	085.004226	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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