Individual
DR. EDMUND C. BOLTON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
120 N OAK ST, HINSDALE, IL 60521-3829
(630) 856-6782
Mailing address
2 OAK BROOK CLUB DR. UNIT C 104, OAK BROOK, IL 60523
(630) 941-8690
(630) 941-8689
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
36-047162
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36-047162
—
IL
Enumeration date
02/15/2006
Last updated
07/08/2007
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