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General NPI Number Information
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NPI Number | 1649390014
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Entity Type | Individual
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Provider Name | ROBERT WARREN BOER DC, PA
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Gender | Male
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 08/28/2012
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Provider Practice Location Address
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Address Line | 23 N LINCOLNWAY
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City | NORTH AURORA
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State | IL
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Zip | 60542-1635
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Country | US
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Telephone | 630-966-2637
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Fax | 630-966-1611
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Provider Business Mailing Address
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Address Line | 23 N LINCOLNWAY
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City | NORTH AURORA
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State | IL
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Zip | 60542-1635
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Country | US
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Telephone | 630-966-2637
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Fax | 630-966-1611
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038007485
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085002500
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License Number State | IL
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