# DR. DANIEL THEODORE BOEDER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1669039822
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0800X | Psychiatry Physician | 036168173 | IL | — |
| 2084P0800X | Psychiatry Physician | 125.073980 | IL | — |
| 2084P0800X | Psychiatry Physician | 2025030304 | MO | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | 036168173 | IL | Yes |
| 2084P0804X | Child & Adolescent Psychiatry Physician | 125.073980 | IL | Yes |
| 2084P0804X | Child & Adolescent Psychiatry Physician | 2025030304 | MO | — |

## Other

- **Enumeration date:** 05/23/2019
- **Last updated:** 08/27/2026