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NPI Code Detail

MEDICARE: MAUREEN K BOLON MD

MEDICARE: MAUREEN K BOLON 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
1207RI0200XInfectious Disease Physician036109801IL

General Provider Information

NPI Number : 1851368773
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAUREEN K BOLON MD
Provider Business Mailing Address
First Line : 645 N MICHIGAN AVE STE 900
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2823
Country : US
Telephone Number : 312-695-4994
Fax Number : 312-926-9630
Provider Business Practice Location Address
First Line : 676 N SAINT CLAIR ST STE 940
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2945
Country : US
Telephone Number : 312-926-8358
Fax Number : 312-926-9630
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2006
Last Update Date : 01/10/2020

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Directions to “ MAUREEN K BOLON MD” Practice Location

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