Individual
DR. JOHN J BOEREN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
311 W LINCOLN ST, SUITE 300, BELLEVILLE, IL 62220-1902
(618) 234-2566
(618) 234-5650
Mailing address
311 W LINCOLN ST, SUITE 300, BELLEVILLE, IL 62220-1902
(618) 234-2566
(618) 234-5650
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0150523
UNITED HEALTHCARE
—
01
—
08215273
BCBS IL
—
01
—
117951
HEALTHLINK
—
01
—
127868
BCBS MO
—
01
—
166403
GROUP HEALTH PLAN
—
01
—
5648285
AETNA
—
01
—
80015974
RR MEDICARE
—
Enumeration date
09/29/2005
Last updated
07/08/2007
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