Basic Information
| Provider Information | |||||||||
| NPI: | 1891963773 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOYD | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | PRESTON | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1001 S 2ND ST | ||||||||
| Address2: | |||||||||
| City: | ST CHARLES | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601744104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305135346 | ||||||||
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| Practice Location | |||||||||
| Address1: | 934 CEDAR AVE | ||||||||
| Address2: | |||||||||
| City: | ELGIN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601202944 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8474298750 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2008 | ||||||||
| LastUpdateDate: | 02/13/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 4704216292 | MI | Y | Nursing Service Providers | Registered Nurse | 163W00000X | IL | N | Nursing Service Providers | Registered Nurse |
No ID Information.