Individual
DR. ROGER BOODOO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(312) 355-2095
Mailing address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A92879
CA
Other
Enumeration date
07/03/2006
Last updated
08/10/2016
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