Boley, Charles K.
Boley, Charles K. is an individual health care provider with primary practice located at 10 Saint Clare Ct Ste 100 , Washington IL 61571-9239. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Boley, Charles K. can be contacted via phone (309) 886-4000.Contact Information
Primary practice address
10 Saint Clare Ct Ste 100
Washington IL 61571-9239
Phone: (309) 886-4000
Fax: (309) 886-4118
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036-115574 | Illinois |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036-115574 | Illinois |
Profile Details
| NPI number | 1912126640 |
|---|---|
| LBN Legal business name | Boley, Charles K. |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 24th, 2007 |
| Last updated | Jun 6th, 2008 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912126640 | NPPES |
| Other | P00401636 | RR MEDICARE | |
| Other | 833230 | RR MEDICARE | |
| Other | CA4079 | RR MEDICARE | |
| MEDICAID | 036115574 | RR MEDICARE |
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