# JOHN BOLDEN M.D. S.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891977294
- **Authorized official:** JOHN BOLDEN JR. M.D. (OWNER)
- **Authorized official phone:** (708) 349-0055

## Contact information

- **Practice address:** 114 W WAVERLY ST, MORRIS, IL 60450-1422
- **Practice address phone:** (708) 349-0055
- **Mailing address:** 10660 W 143RD ST STE B, ORLAND PARK, IL 60462-1989
- **Mailing address phone:** (708) 349-0055
- **Mailing address fax:** (708) 460-8031

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | 036106844 | IL | Yes |

## Other

- **Enumeration date:** 11/28/2007
- **Last updated:** 02/03/2011