Organization
BOUGHTON FAMILY PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD A LOFTHOUSE MD (OWNER)
(630) 410-2448
Entity
Organization
Contact information
Practice address
402 W BOUGHTON RD STE F1, BOLINGBROOK, IL 60440-1984
(630) 410-2448
(630) 410-8327
Mailing address
PO BOX 278, CLARENDON HILLS, IL 60514-0278
(630) 410-2448
(630) 410-8327
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/27/2014
Last updated
02/21/2019
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