Organization
BOFFA MEDICAL GROUP LLC
Active
Other names
Boffa Surgical Group, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES FRANK BOFFA MD (PARTNER)
(773) 273-6810
Entity
Organization
Contact information
Practice address
5140 N CALIFORNIA AVE, SUITE 780, CHICAGO, IL 60625-3645
(773) 273-6810
(773) 273-5532
Mailing address
5140 N CALIFORNIA AVE, SUITE 780, CHICAGO, IL 60625-3645
(773) 273-6810
(773) 273-5532
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
IL
2086X0206X
Surgical Oncology Physician
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001630046
BCBS OF IL GROUP NUMBER
IL
Enumeration date
08/14/2006
Last updated
09/28/2009
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