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Contact Information

ABIGAIL BOETHIN, P.A.-C
611 W PARK ST
FAPC
URBANA, IL61801
 Phone: 217-904-7000
 Fax: 217-904-7748
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Medical

363AM0700X 97 Physician Assistant
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for ABIGAIL BOETHIN · (Female)

NPI Number 1023369212
Status Active
Credentials P.A.-C
Entity Individual
Enumeration date 09/27/2012
Last updated 06/11/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 085007968
  • MO License # 2012033522
Hospital affiliation(s)
  • CARLE FOUNDATION HOSPITAL - (Acute Care)
    611 WEST PARK STREET
    URBANA, IL 61801
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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