Individual
DANA BOZEDAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070015281
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619980
BCBS OF IL
IL
01
—
1623066
BCBS PROVIDER #
IL
01
—
367885100
US DEPT OF LABOR PROV.#
IL
01
—
CJ4383
R.R. MEDICARE GRP#
IL
01
—
CJ8115
RR MEDICARE GRP#
IL
Enumeration date
09/29/2006
Last updated
10/07/2009
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