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Individual

BRIAN ROBERT BOULAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1740 W TAYLOR ST, UIC MEDICAL CENTER, SECTION OF DIGESTIVE DISEASES, CHICAGO, IL 60612-0199
(312) 355-4270
(312) 996-5103
Mailing address
3920 N SHERIDAN RD, APT 504, CHICAGO, IL 60613-5493
(802) 356-7432

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036.125568
IL
207RG0100X
Gastroenterology Physician
13031
NH
207RG0100X
Gastroenterology Physician
A107914
CA

Other

Enumeration date
10/03/2006
Last updated
06/03/2010
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