| Mrs Linda Georgette Boulware, APRN | |
|
2045 W Grand Ave Ste B, Chicago, IL 60612-1577 | |
| (888) 660-4425 | |
| Not Available |
| Full Name | Mrs Linda Georgette Boulware |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 6 Years |
| Location | 2045 W Grand Ave Ste B, Chicago, Illinois |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063000669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 209.022606 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ssm Health - Good Samaritan Hospital | Mount vernon, IL | Hospital |
| Ssm Health St Mary's Hospital -centralia | Centralia, IL | Hospital |
| Crossroads Community Hospital | Mount vernon, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Physician Services Corporation Of Southern Illinois Inc | 9234022567 | 103 |
| Specialized Wound Management Llc | 4284628173 | 3 |
| Select Physical Therapy Holdings Inc | 9537076401 | 1463 |
| Entity Name | Physician Services Corporation Of Southern Illinois Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831101807 PECOS PAC ID: 9234022567 Enrollment ID: O20040304000583 |
| Entity Name | Specialized Wound Management Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962430157 PECOS PAC ID: 4284628173 Enrollment ID: O20040505000688 |
| Entity Name | Perspective Behavioral And Pain Solutions Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326671702 PECOS PAC ID: 1951732106 Enrollment ID: O20200504001274 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Linda Georgette Boulware, APRN 1591 Abbott St, Carlyle, IL 62231-1107 Ph: (618) 741-8431 | Mrs Linda Georgette Boulware, APRN 2045 W Grand Ave Ste B, Chicago, IL 60612-1577 Ph: (888) 660-4425 |
Mr. Gerald M. Bedore, APN/CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 835 S Wolcott Ave Rm E-144, Chicago, IL 60612 Phone: 312-996-7420 Fax: 312-413-8485 | |
Stacy Ervin, APN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 401 N Michigan Ave, Chicago, IL 60611 Phone: 866-825-3227 | |
Katherine Cappitelli, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 676 N Saint Clair St Ste 2125, Chicago, IL 60611 Phone: 312-472-4218 | |
Mindy Unrau, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2045 W. Grand Ave Ste. B, Pmb 89496, Chicago, IL 60612 Phone: 708-630-1534 | |
Juliet Ibanez Panambo Kantoff, AGPCNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 401 N Michigan Ave Ste 1200, Chicago, IL 60611 Phone: 312-635-0973 | |
Catherine L Chung, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2142 S Archer Ave, Chicago, IL 60616 Phone: 312-326-1408 | |
Tricia Muir, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 850 W Irving Park Rd, Chicago, IL 60613 Phone: 773-525-6780 |