JOHN BOLDEN M.D. S.C. (NPI# 1891977294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891977294 |
| Entity Type | Organization |
| Organization Name | JOHN BOLDEN M.D. S.C. |
| Practice Address |
114 W Waverly St Morris IL 60450-1422 |
| Mailing Address |
10660 W 143rd St Ste B Orland Park IL 60462-1989 |
| Practice Telephone | 7083490055 |
| Mailing Telephone | 7083490055 |
| Mailing Fax Number | 7084608031 |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2011-02-03 |
| Authorized Official Name | JOHN BOLDEN JR. (OWNER) |
| Authorized Official Telephone | 7083490055 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
036106844 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD | 03232029 | 01 |
| IL | PALMETTO RR MEDICARE | DE2561 | 01 |
| IL | 036106844 | 05 |
| Street Address |
114 W WAVERLY ST |
| City | MORRIS |
| State | IL |
| Zip Code | 60450-1422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891873113 | Olga Marie Peplos | Internal Medicine | 114 W Waverly St, Morris, IL 60450 | 2006-11-02 |
| 1376896506 | Kucinski Medical Ltd | Internal Medicine | 114 W Waverly St, Morris, IL 60450-1422 | 2012-10-25 |
| 1093010126 | Laura Jean Kucinski | Internal Medicine | 114 W Waverly St, Morris, IL 60450-1422 | 2011-01-21 |
| 1699853911 | Olga M Peplos Md PC | Internal Medicine | 114 W Waverly St, Morris, IL 60450-1422 | 2006-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144691 | Jessica Kubinski | Occupational Therapist | 1051 W, Us-6, Morris, IL 60450 | 2020-11-03 |
| 1922646652 | Anna Doherty | Counselor | Crossroads Counseling Services, 1802 N Division St Suite 509, Morris, IL 60450 | 2019-12-12 |
| 1003353764 | Crossroads Counseling Services, LLC | Community/Behavioral Health | 1802 N Division Street, Suite 509, Morris, IL 60450 | 2017-01-19 |
| 1780128249 | Lori Lynn Peterson | Nurse Practitioner | 8805 N Tabler Road, Health & Wellness Clinic, Morris, IL 60450 | 2016-12-18 |
| 1639613532 | Jodi Lynn Valencia | Licensed Practical Nurse | 114 E. Benton St., Morris, IL 60450 | 2016-12-12 |
| 1184001844 | Ashish G. Suthar | Pharmacist | 1600 West Route 6, Morris, IL 60450 | 2015-05-01 |
| 1255690574 | Tammy S. Zweeres | Nurse Practitioner | 936 W. U.S. Route 6, Morris, IL 60450 | 2012-05-07 |
| 1952682742 | Marie E Monhardt | Nurse Practitioner | 801 So Washington Str, Naperville, IL 60450 | 2011-09-07 |
| 1093024200 | Diane Marie Zuelke | Nurse Practitioner | 1802 N Division St Ste 703, Morris, IL 60450 | 2010-10-05 |
| 1063669182 | Athletic & Therapeutic Institute of Naperville, LLC | Physical Therapist | 201 East U.S. Route 6, Morris, IL 60450 | 2008-08-20 |
| Find all providers in zip 60450 | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073666707 | John Bolden Jr. | Internal Medicine | 425 E Us Route 6, Morris, IL 60450-9042 | 2007-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437775038 | Aids Healthcare Foundation | Internal Medicine | 2600 S Michigan Ave # Ll-d, Chicago, IL 60616-2857 | 2020-06-19 |
| 1972152874 | Amanda M Zimmermann | Internal Medicine | 1870 W Winchester Rd Ste 247, Libertyville, IL 60048-5360 | 2019-09-04 |
| 1992213896 | Jennifer Marie Bassler | Internal Medicine | 7804 W College Dr Ste 1n, Palos Heights, IL 60463-1499 | 2018-01-14 |
| 1699201582 | Id Associates Limited | Internal Medicine | 5 Hunt Club Ln, Oak Brook, IL 60523-2328 | 2017-05-11 |
| 1053773044 | Seshank Arimilli | Internal Medicine | 2160 S 1st Ave Bldg 1027609, Maywood, IL 60153-3328 | 2016-03-28 |
| 1265859607 | Alessandra Anna Secco | Internal Medicine | 7900 N Milwaukee Ave Ste 231a, Niles, IL 60714-3247 | 2014-03-24 |
| 1275962672 | Saira Rashida Ajmal | Internal Medicine | 4440 W 95th St Ste 301, Oak Lawn, IL 60453 | 2013-11-06 |
| 1942542519 | Andrew Blatt Thompson | Internal Medicine | 901 Mcclintock Dr Ste 201, Burr Ridge, IL 60527 | 2013-03-21 |
| 1013259779 | Allan Joseph Weinstein | Internal Medicine | 65 E Goethe St, Chicago, IL 60610-2628 | 2013-03-20 |
| 1871832428 | Harvey Kantor | Internal Medicine | 313 Whitmore Ln, Lake Forest, IL 60045-4707 | 2013-02-01 |
| 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.