| Doctor Name: | DR. JEFFREY MARC BOORSTEIN |
| NPI Number: | 1003862806 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | |
| Business Practice Address: | 2300 N Edward St Decatur, IL - 625264163 |
| Business Phone Number: | 2178762300 |
| Business Fax Number: | 2178766725 |
| Mailing Address: | 2300 N Edward St, DECATUR |
| State: | IL |
| Postal Code: | 625264163 |
| Phone Number: | 2178762300 |
| Fax Number: | 2178766725 |
| NPI Enumeration Date: | 05/25/2006 |
| NPI Last Update Date: | 01/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085N0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Neuroradiology |
| Taxonomy Definition: | A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children. |