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Contact Information

JOHN L BOSTANCHE, DPM
6123 GREEN BAY RD
STE 100
KENOSHA, WI53142-2939
 Phone: 262-657-3668
 Fax: 262-652-0564
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for JOHN L BOSTANCHE · (Male)

NPI # 1821092420
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 06/10/2005
Last updated 05/05/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 016004510
  • WI License # 654025
  • WI Medicaid 43215000
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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