Boehm, Jacob Dalton

Boehm, Jacob Dalton is an individual health care provider with primary practice located at 409 Illinois Ave Unit 1D , St Charles IL 60174-2966. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Boehm, Jacob Dalton can be contacted via phone (630) 974-6602.

Contact Information

Primary practice address
409 Illinois Ave Unit 1D St Charles IL 60174-2966
Phone: (630) 974-6602
Fax: (630) 487-2411
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X Illinois
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 085.007272 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085.007272 Illinois

Profile Details

NPI number 1932741717
LBN Legal business name Boehm, Jacob Dalton
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2019
Last updated Nov 13th, 2023 - about last year

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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