DR. BRANDI KRISTEN BOAN (NPI# 1780862219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780862219 |
| Entity Type | Individual |
| Full Name | DR. BRANDI KRISTEN BOAN |
| Credential | PSYD |
| Practice Address |
417 N Main St Sandwich IL 60548-1569 |
| Practice Telephone | 6306492819 |
| Mailing Telephone | 6306492819 |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2020-10-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
180.007281 | IL | Behavioral Health & Social Service Providers |
| N | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers | ||
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
071008926 | IL | Behavioral Health & Social Service Providers |
| N | 103TP0016X |
Psychologist Specialization: Prescribing (Medical) |
074000002 | IL | Behavioral Health & Social Service Providers |
| Street Address |
417 N MAIN ST |
| City | SANDWICH |
| State | IL |
| Zip Code | 60548-1569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972117521 | The Brain Clinic, LLC | Clinical Neuropsychologist | 417 N Main St, Sandwich, IL 60548-1569 | 2020-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366954166 | Northern Rehabilitation and Sports Medicine Associates | Physical Therapist | 523 E. Railroad Street, Suite A, Sandwich, IL 60548 | 2017-11-02 |
| 1538683040 | Ariel Eads | Counselor | 207 E Church St Unit A, Sandwich, IL 60548 | 2017-07-27 |
| 1093169138 | Kimberly S Miner | Acupuncturist | 100 South Latham Street, Suite 103b, Sandwich, IL 60548 | 2016-04-14 |
| 1316304058 | Dekalb Behavioral Health Foundation, Inc. | Clinic/Center | 100 S Latham St Ste 204, Sandwich, IL 60548 | 2016-01-26 |
| 1215006200 | Robert C Lerohl | Dentist | 430 S. Dayton Street, Sandwich, IL 60548 | 2006-11-06 |
| 1609950641 | Joseph Jimenez | Chiropractor | 823 E Church St, Sandwich, IL 60548 | 2006-10-25 |
| 1104919703 | Pharmacy Operations, Inc | Pharmacy | 142 Indian Springs Drive, Sandwich, IL 60548 | 2006-10-02 |
| 1902911076 | Jason Lee Robinson | Physical Therapist | 710 E Railroad St, Sandwich, IL 60548 | 2006-08-20 |
| 1982719209 | Anchor Dental Center Ltd | Dentist | 100 S Latham St, Sandwich, IL 60548 | 2006-08-19 |
| 1376566745 | Sandwich Community Fire Protection District | Ambulance | 310 E Railroad St, Sandwich, IL 60548 | 2006-07-25 |
| Find all providers in zip 60548 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225426570 | Jennifer Lynn Pellicano | Psychologist | 207 E Church St, Suite A, Sandwich, IL 60548-9803 | 2015-01-08 |
| 1821346693 | The Sandwich Center, Inc. | Psychologist | 449 Route 130, Sandwich, MA 02563-2339 | 2012-08-27 |
| 1063408250 | Timothy R. Buhrt | Psychologist | 207 E Church St, Suite A, Sandwich, IL 60548-9803 | 2005-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699166 | Jennifer Knuepfer, Psyd, Pllc | Psychologist | 4256 N Ravenswood Ave Ste 305, Chicago, IL 60613-1114 | 2020-11-03 |
| 1104426170 | Grace Giedgowd | Psychologist | 1640 W Division St Apt 205, Chicago, IL 60622-3939 | 2020-10-29 |
| 1417556283 | Kjp Alliance LLC | Psychologist | 16595 W Easton Ave Ste 1, Lincolnshire, IL 60069-2744 | 2020-10-22 |
| 1184223364 | Caroline Elisabeth Fulton | Psychologist | 1739 N Elston Ave, Chicago, IL 60642-1544 | 2020-10-20 |
| 1881293108 | Haley Michelle Sims | Psychologist | 65 E Wacker Pl Ste 300, Chicago, IL 60601-7203 | 2020-10-19 |
| 1083212005 | Amanda Michele Long | Psychologist | 20280 Governors Hwy Ste 105, Olympia Fields, IL 60461-1068 | 2020-10-12 |
| 1285231936 | Qianhui Zhang | Psychologist | 1225 W Morse Ave Apt 403, Chicago, IL 60626-5751 | 2020-10-06 |
| 1316544158 | Nancy Marie Picard | Psychologist | 4885 N Hermitage Ave, Chicago, IL 60640-4104 | 2020-10-05 |
| 1558978379 | Youngok Kim | Psychologist | 1260 Iroquois Ave Ste 204, Naperville, IL 60563-8548 | 2020-09-25 |
| 1861007049 | Heloisa Garman | Psychologist | 800 Elgin Rd Apt 1611, Evanston, IL 60201-5632 | 2020-09-14 |
| Find all providers with the same taxonomy | ||||
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| 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.