Individual
STEPHEN WILLIAM BOUDRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
287 W BUTTERFIELD RD, ELMHURST, IL 60126-5037
(630) 617-5444
Mailing address
287 W BUTTERFIELD RD, ELMHURST, IL 60126-5037
(630) 617-5444
Taxonomy
Speciality
Code
Description
License number
State
111NI0900X
Internist Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001682440
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/12/2006
Last updated
07/08/2007
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