Provider Demographics
NPI:1801882824
Name:BOULE, NATALIE (PT)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:BOULE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 N HIGHLAND AVE STE B
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-1469
Mailing Address - Country:US
Mailing Address - Phone:630-892-4286
Mailing Address - Fax:630-892-2104
Practice Address - Street 1:1320 N HIGHLAND AVE STE B
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-1469
Practice Address - Country:US
Practice Address - Phone:630-892-4286
Practice Address - Fax:630-892-2104
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-011764225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q07465Medicare UPIN
K03924Medicare ID - Type Unspecified