Boch, Phillip A.

Boch, Phillip A. is an individual health care provider with primary practice located at 6320 Cermak Rd , Berwyn IL 60402-2812. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Boch, Phillip A. can be contacted via phone (708) 749-3777.

Contact Information

Primary practice address
6320 Cermak Rd Berwyn IL 60402-2812
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036-054799 Illinois

Profile Details

NPI number 1699767186
LBN Legal business name Boch, Phillip A.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Dec 6th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699767186 NPPES
Illinois Other 363033456 FEDERAL TAX ID
Illinois Other 9530608003 FEDERAL TAX ID
Illinois Other 4656516 FEDERAL TAX ID
Illinois Other 120001237 FEDERAL TAX ID
Illinois Other 21607418 FEDERAL TAX ID

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