MEDICARE: KEITH R BOYD MD

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	207L00000X	Anesthesiology Physician	036 121107	IL

General Provider Information

NPI Number	:	1548422496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEITH R BOYD MD

Provider Business Mailing Address
First Line	:	2937 W 63RD ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60629-2753
Country	:	US
Telephone Number	:	773-309-0141
Fax Number	:	773-309-0147

Provider Business Practice Location Address
First Line	:	2937 W 63RD ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60629
Country	:	US
Telephone Number	:	773-309-0141
Fax Number	:	773-309-0147

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

Provider Enumeration Date	:	07/01/2008
Last Update Date	:	07/21/2022

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