Healthcare Provider Details

I. General information

NPI: 1225942980
Provider Name (Legal Business Name): ISABELLA MARIE BOCCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 N WASHINGTON ST
NAPERVILLE IL
60540-4558
US

IV. Provider business mailing address

890 FOTIS DR APT 5
DEKALB IL
60115-6574
US

V. Phone/Fax

Practice location:
  • Phone: 630-358-9482
  • Fax:
Mailing address:
  • Phone: 224-231-7663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number208.011764
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: