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Individual
DR. DANIEL THEODORE BOEDER
Active
Individual
DR. DANIEL THEODORE BOEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
036168173
IL
2084P0800X
Psychiatry Physician
125.073980
IL
2084P0800X
Psychiatry Physician
2025030304
MO
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
036168173
IL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
125.073980
IL
2084P0804X
Child & Adolescent Psychiatry Physician
2025030304
MO
Other
Enumeration date
05/23/2019
Last updated
08/27/2026
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