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Individual

DR. KEVIN DALE BOATWRIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2150 PFINGSTEN RD STE 3000, GLENVIEW, IL 60026-1314
(847) 657-5959
(847) 657-5764
Mailing address
2150 PFINGSTEN RD STE 3000, GLENVIEW, IL 60026-1314
(847) 657-5959
(847) 657-5764

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036131723
IL
207RI0200X
Infectious Disease Physician
Primary
036131723
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
142VX
BCBS
NC
01
1508102
CIGNA
NC
01
194228
MEDCOST
NC
01
200157944
KEY RISK WC
NC
01
2696737
UNITED HEALTHCARE
NC
01
460264
WELLPATH
NC
05
5904223
NC
01
7474886
AETNA
NC
01
DD2526
PALMETTO GBA
NC
Enumeration date
07/07/2006
Last updated
02/16/2021
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