Provider Demographics
NPI:1437216272
Name:BOYCE, CATHERINE
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:
Last Name:BOYCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 JUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-1315
Mailing Address - Country:US
Mailing Address - Phone:773-983-4444
Mailing Address - Fax:
Practice Address - Street 1:636 CHURCH ST STE 321
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4579
Practice Address - Country:US
Practice Address - Phone:773-983-8444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490077391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PTAN IL 2855Medicare PIN