Search › Illinois › 363A00000X
Jacob Boehm, PA-C
NPI 1932741717 · on the registry since 2019
Practice
- Address
- 409 Illinois Ave Unit 1d
St Charles, IL 60174 - Phone
- (630) 974-6602
- Fax
- (630) 487-2411
- Clinicians at this address
- 7
Additional practice sites
- 1200 W State St, Rockford, IL
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Also registered as
- 363A00000X
363AM0700X - Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-11-22
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois