Individual
BOAZ YEHUDA BISHOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
251 E HURON ST, CHICAGO, IL 60611-2908
(754) 399-5408
Mailing address
525 W HAWTHORNE PL APT 2104, CHICAGO, IL 60657-2905
(754) 399-5408
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1-35773
ZZ
207RN0300X
Nephrology Physician
Primary
125.076182
IL
Other
Enumeration date
03/28/2020
Last updated
06/23/2020
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