MEDICARE: DARLA BOYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide

General Provider Information

NPI Number	:	1093233249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARLA BOYD

Provider Business Mailing Address
First Line	:	1010 DIXIE HWY FL 4
Second Line	:
City	:	CHICAGO HEIGHTS
State	:	IL
Zip	:	60411-2663
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18036 HIGHLAND AVE
Second Line	:
City	:	TINLEY PARK
State	:	IL
Zip	:	60477-4271
Country	:	US
Telephone Number	:	708-429-3835
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2017
Last Update Date	:	09/07/2017

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Directions to “ DARLA BOYD ” Practice Location

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