JEFFREY S BOBERG DPM LLC (NPI# 1710147236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710147236 |
| Entity Type | Organization |
| Organization Name | JEFFREY S BOBERG DPM LLC |
| Other Organization Name | ANKLE & FOOT SURGEONS OF THE MIDWEST |
| Practice Address |
180 S 3rd St Ste 103 Belleville IL 62220-1952 |
| Practice Telephone | 6182367444 |
| Mailing Telephone | 6182367444 |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2008-07-17 |
| Authorized Official Name | DR. JEFFREY S BOBERG (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 6182367444 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
016004233 | IL | Podiatric Medicine & Surgery Service Providers |
| Other Name | Type Code |
|---|---|
| Ankle & Foot Surgeons of the Midwest | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639280290 | Jeffrey S Boberg Dpm LLC | Podiatrist | 12255 De Paul Dr, Ste 100, Bridgeton, MO 63044-2510 | 2006-08-31 |
| Street Address |
180 S 3RD ST STE 103 |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62220-1952 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477548238 | Rhonda G Ozanian | Social Worker | 180 S 3rd St, Suite 400, Belleville, IL 62220-1952 | 2005-09-16 |
| 1346690625 | Dane Bay | Family Medicine | 180 S 3rd St, Suite 300, Belleville, IL 62220-1952 | 2016-06-16 |
| 1518317056 | Joseph August Yoha | Family Medicine | 180 S 3rd St, Suite 300, Belleville, IL 62220-1952 | 2016-06-15 |
| 1548610017 | Daniela Vincent | Family Medicine | 180 S 3rd St, Suite 300, Belleville, IL 62220-1952 | 2016-06-15 |
| 1568811321 | Marcus R Hennon | Family Medicine | 180 S 3rd St, Belleville, IL 62220-1952 | 2016-06-11 |
| 1518316728 | Sana Usman | Family Medicine | 180 S 3rd St, Suite 300, Belleville, IL 62220-1952 | 2016-06-08 |
| 1053769992 | Michelle Baker | Family Medicine | 180 S 3rd St, Belleville, IL 62220-1952 | 2016-06-01 |
| 1356722151 | Imran Khan | Family Medicine | 180 S 3rd St, Suite 300, Belleville, IL 62220-1952 | 2015-06-17 |
| 1790166965 | Jennifer Woosley | Family Medicine | 180 S 3rd St, Suite 300, Belleville, IL 62220-1952 | 2015-06-14 |
| 1619358900 | Gretta Carroll | Family Medicine | 180 S 3rd St, Suite 300, Belleville, IL 62220-1952 | 2015-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144729716 | St. Elizabeth's Hospital of The Hospital Sisters of The Third Order Of | Clinic/Center | 180 South Third Street Suite 101, Belleville, IL 62220 | 2018-02-08 |
| 1437675535 | Prorehab PC | Occupational Therapist | 1915 Carlyle Ave, Ste D, Belleville, IL 62220 | 2017-08-21 |
| 1629527650 | Arika Forrest | Nurse Practitioner | 140 Iowa Ave, Belleville, IL 62220 | 2016-10-03 |
| 1861861403 | Belleville Endoscopy LLC | Internal Medicine | 311 West Lincoln St, Suite 101, Belleville, IL 62220 | 2015-09-24 |
| 1962871558 | Antony Frierdich | Specialist/Technologist | 22 South 13th Street, Belleville, IL 62220 | 2015-09-24 |
| 1588032858 | Dana Wright | Pharmacist | 211 South Thrid Street, Belleville, IL 62220 | 2015-09-03 |
| 1629208731 | Lisa Marlow Johnson | Developmental Therapist | 34 Fenwood Dr, Belleville, IL 62220 | 2009-07-23 |
| 1841361623 | Neurological Surgery of Belleville | Neurological Surgery | 340 West Lincoln Street, Suite 540, Belleville, IL 62220 | 2006-11-13 |
| 1689769119 | Kathy Jo Corn | Counselor | 521 W. Main, Suite 201 B, Belleville, IL 62220 | 2006-10-03 |
| 1780609578 | Southern Illinois Health Care Foundation, Inc. | Counselor | 180 S 3rd St Ste 103&104, Belleville, IL 62220 | 2006-07-13 |
| Find all providers in zip 62220 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891270609 | Syracuse Medical LLC | Podiatrist | 5 Franklin Ave Ste 103, Belleville, NJ 07109-3521 | 2018-09-27 |
| 1740690874 | Advance Foot Care, LLC | Podiatrist | 192 Branch Brook Dr, Belleville, NJ 07109-3607 | 2014-04-28 |
| 1770615148 | Foot Surgery Center LLC | Podiatrist | 4901 W Main St, Belleville, IL 62226-4724 | 2007-03-12 |
| 1811078884 | Wendy K. Stinson Dpm | Podiatrist | 286 Union Ave, Lower Level, Belleville, NJ 07109-2053 | 2006-10-18 |
| 1699889535 | John Cozzarelli | Podiatrist | 155 Belleville Ave, Belleville, NJ 07109-2407 | 2006-08-18 |
| 1699715094 | Victor L Horsley | Podiatrist | 4901 West Main, Belleville, IL 62226 | 2006-06-07 |
| 1316398613 | Annette Buron | Podiatrist | 155 Belleville Ave, Belleville, NJ 07109-2407 | 2016-06-28 |
| 1649620634 | Neil Ermitano | Podiatrist | 2900 Frank Scott Pkwy W Ste 900, Belleville, IL 62223-5000 | 2016-06-21 |
| 1740653591 | Associated Foot Surgeons of Southwest Illinois, Ltd. | Podiatrist | 2900 Frank Scott Pkwy W, Ste 900, Belleville, IL 62223-5000 | 2015-11-02 |
| 1114289121 | Amanda M Hart | Podiatrist | 2900 Frank Scott Pkwy W, Suite 900, Belleville, IL 62223-5000 | 2012-06-14 |
| Find all providers in BELLEVILLE | ||||
| City | BELLEVILLE |
| Zip Code | 62220 |
Please comment or provide details below to improve the information on JEFFREY S BOBERG DPM LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.