Healthcare Provider Details

I. General information

NPI: 1568396299
Provider Name (Legal Business Name): JOLIE M BOROS AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9046 COLUMBIA AVE STE A
MUNSTER IN
46321-2905
US

IV. Provider business mailing address

9046 COLUMBIA AVE STE A
MUNSTER IN
46321-2905
US

V. Phone/Fax

Practice location:
  • Phone: 219-703-2460
  • Fax: 219-703-6776
Mailing address:
  • Phone: 219-703-2460
  • Fax: 219-703-6776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number23002956A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: