Provider Demographics
NPI:1811578958
Name:BOSLET, EMMA HALLIE (MD)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:HALLIE
Last Name:BOSLET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:180 HARVESTER DR STE 110
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-6686
Mailing Address - Country:US
Mailing Address - Phone:773-702-1150
Mailing Address - Fax:
Practice Address - Street 1:5841 S MARYLAND AVE # MC4028
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1443
Practice Address - Country:US
Practice Address - Phone:773-702-6842
Practice Address - Fax:773-834-0063
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036173226207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RILP05695OtherRHODE ISLAND BOARD OF MEDICINE
FLTRN33937OtherFLORIDA BOARD OF MEDICINE
IL036173226OtherIDFPR