Provider Demographics
NPI:1003019894
Name:BOLING MEDICAL LLC
Entity type:Organization
Organization Name:BOLING MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUMA
Authorized Official - Middle Name:REDDY
Authorized Official - Last Name:KAKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-335-7878
Mailing Address - Street 1:2315 HAZEL CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-5239
Mailing Address - Country:US
Mailing Address - Phone:630-335-7878
Mailing Address - Fax:
Practice Address - Street 1:2315 HAZEL CT
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-5239
Practice Address - Country:US
Practice Address - Phone:630-335-7878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty