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Organization

STEPHEN P. BOGHOSSIAN, M.D., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEPHEN P. BOGHOSSIAN M.D. (PRESIDENT)
(630) 834-7590
Entity
Organization

Contact information

Practice address
1200 S YORK RD, SUITE 4240, ELMHURST, IL 60126-5626
(630) 834-7590
(630) 516-9123
Mailing address
PO BOX 6851, VILLA PARK, IL 60181-6851
(630) 834-7590
(630) 516-9123

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02226004
BLUE CROSS
IL
01
17-11003
UNITED HEALTHCARE
IL
Enumeration date
02/15/2008
Last updated
02/15/2008
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