Provider Demographics
NPI:1184726697
Name:OPTIMAL HEALTH LTD
Entity type:Organization
Organization Name:OPTIMAL HEALTH LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-926-5123
Mailing Address - Street 1:6806 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-6967
Mailing Address - Country:US
Mailing Address - Phone:630-325-6534
Mailing Address - Fax:630-590-5027
Practice Address - Street 1:2929 S ELLIS AVE
Practice Address - Street 2:OPTIMAL SLEEP CENTER, GROUND FLOOR SINGER PAVILION
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-3395
Practice Address - Country:US
Practice Address - Phone:312-791-3568
Practice Address - Fax:312-791-3569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK02602OtherMEDICARE PIN #
IL1633677OtherBLUE CROSS PROVIDER #
ILF62741Medicare UPIN
IL207821Medicare ID - Type UnspecifiedMEDICARE GROUP PROVIDER #