Individual
DEREK LANCE BOHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1200 S YORK ST, ELMHURST, IL 60126-5626
(630) 646-6020
(331) 221-2341
Mailing address
2650 RIDGE AVE STE 1223, EVANSTON, IL 60201-1700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
IL
363AS0400X
Surgical Physician Assistant
Primary
085011428
IL
Other
Enumeration date
05/13/2025
Last updated
02/23/2026
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