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NPI Code Detail

MEDICARE: JAMES VAN DEN BOGAERDE M.D.

MEDICARE: JAMES VAN DEN BOGAERDE M.D.
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
1207X00000XOrthopaedic Surgery PhysicianA067663CA
2207X00000XOrthopaedic Surgery Physician036165932IL

General Provider Information

NPI Number : 1588624522
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES VAN DEN BOGAERDE M.D.
Provider Business Mailing Address
First Line : 1025 MAINE ST
Second Line :
City : QUINCY
State : IL
Zip : 62301-4096
Country : US
Telephone Number : 217-222-6550
Fax Number :
Provider Business Practice Location Address
First Line : 1118 HAMPSHIRE ST
Second Line :
City : QUINCY
State : IL
Zip : 62301-3027
Country : US
Telephone Number : 217-222-6550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2006
Last Update Date : 08/10/2023

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Directions to “ JAMES VAN DEN BOGAERDE M.D.” Practice Location

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