Provider Demographics
NPI:1841099413
Name:BOEHM, DANETTE MCHUGH (MS, RN, IBCLC)
Entity type:Individual
Prefix:
First Name:DANETTE
Middle Name:MCHUGH
Last Name:BOEHM
Suffix:
Gender:
Credentials:MS, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 ECLIPSE DR
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-3610
Mailing Address - Country:US
Mailing Address - Phone:847-436-8258
Mailing Address - Fax:
Practice Address - Street 1:253 ECLIPSE DR
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-3610
Practice Address - Country:US
Practice Address - Phone:847-436-8258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-212003I163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse