Individual
BOSS POVIENG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1620 W HARRISON ST STE 403, CHICAGO, IL 60612-3801
(312) 942-7100
Mailing address
1620 W HARRISON ST STE 403, CHICAGO, IL 60612-3801
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
036.168979
IL
Other
Enumeration date
05/15/2020
Last updated
06/26/2024
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