Individual
DR. STEVEN RUSSELL BOAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
191 WAUKEGAN RD STE 200, NORTHFIELD, IL 60093-2743
(847) 998-3434
(847) 998-8584
Mailing address
191 WAUKEGAN RD, STE 200, NORTHFIELD, IL 60093-2743
(847) 998-3434
(847) 998-8584
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036091411
IL
208000000X
Pediatrics Physician
036091411
IL
2080P0214X
Pediatric Pulmonology Physician
Primary
036091411
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36091411
—
IL
Enumeration date
06/28/2005
Last updated
07/30/2024
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