Provider Demographics
NPI:1417210626
Name:BOE, IAN C (DC)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:C
Last Name:BOE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 HOBSON RD STE 132
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-8137
Mailing Address - Country:US
Mailing Address - Phone:331-702-2141
Mailing Address - Fax:
Practice Address - Street 1:1220 HOBSON RD STE 132
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-8137
Practice Address - Country:US
Practice Address - Phone:331-702-2141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.011114111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor