# BOULEVARD MEDICAL ASSOCIATES, SC

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

## Provider details

- **NPI number:** 1982752911
- **Authorized official:** DR. SAVIO MANATT M.D. (PRESIDENT)
- **Authorized official phone:** (708) 754-7777

## Contact information

- **Practice address:** 30 E 15TH ST, SUITE 202, CHICAGO HEIGHTS, IL 60411-3459
- **Practice address phone:** (708) 754-7777
- **Practice address fax:** (708) 754-7701
- **Mailing address:** 30 E 15TH ST, SUITE 202, CHICAGO HEIGHTS, IL 60411-3459
- **Mailing address phone:** (708) 754-7777
- **Mailing address fax:** (708) 754-7701

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 173000000X | Legal Medicine | — | IL | Yes |

## Other

- **Enumeration date:** 01/08/2007
- **Last updated:** 08/22/2020