Boulos, Rida W
Boulos, Rida W is an individual health care provider with primary practice located at Dept Of Ob / Gyn 530 Ne Glen Oak, Peoria IL 61637-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Boulos, Rida W can be contacted via phone (309) 655-3024.Contact Information
Primary practice address
Dept Of Ob / Gyn 530 Ne Glen Oak
Peoria IL 61637-0001
Phone: (309) 655-3024
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | Illinois |
Profile Details
| NPI number | 1114991577 |
|---|---|
| LBN Legal business name | Boulos, Rida W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 14th, 2006 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114991577 | NPPES |
| Illinois | Other | 07215036 | BCBS |
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