Organization
JOHN BOLDEN M.D. S.C.
Active
Organization
JOHN BOLDEN M.D. S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BOLDEN JR. M.D. (OWNER)
(708) 349-0055
Entity
Organization
Contact information
Practice address
114 W WAVERLY ST, MORRIS, IL 60450-1422
(708) 349-0055
Mailing address
10660 W 143RD ST STE B, ORLAND PARK, IL 60462-1989
(708) 349-0055
(708) 460-8031
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
036106844
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03232029
BLUE CROSS BLUE SHIELD
IL
05
—
036106844
—
IL
01
—
DE2561
PALMETTO RR MEDICARE
IL
Enumeration date
11/28/2007
Last updated
02/03/2011
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up