Boughanem, Jay

Boughanem, Jay is an individual health care provider with primary practice located at 676 N Saint Clair St Fl 13 Department Of Orthopaedic Surgery, Chicago IL 60611-3060. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Boughanem, Jay can be contacted via phone (312) 926-4485.

Contact Information

Primary practice address
676 N Saint Clair St Fl 13 Department Of Orthopaedic Surgery Chicago IL 60611-3060
Phone: (312) 926-4485
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 73259-20 Wisconsin
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 036120773 Illinois

Profile Details

NPI number 1518115948
LBN Legal business name Boughanem, Jay
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 27th, 2008
Last updated Jul 11th, 2023 - about 2 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 1518115948 NPPES
Wisconsin MEDICAID 1518115948

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