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Contact Information

DANIEL T BOEDER
319 E MADISON ST FL 3
SPRINGFIELD, IL62701-1035
 Phone: 217-545-6900
 Fax: 217-585-6893
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Child & Adolescent Psychiatry

2084P0804X 86 Physician/Neuropsychiatry
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for DANIEL T BOEDER · (Male)

NPI # 1669039822
Status Active
Credentials
Entity Individual
Enumeration date 05/23/2019
Last updated 06/25/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • IL License # 125.073980
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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