Individual
ALECIA BOEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2900 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4330
(414) 649-6000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7282-023
WI
363AM0700X
Medical Physician Assistant
085005419
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100253001
—
WI
Enumeration date
03/26/2015
Last updated
01/24/2024
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