Jessica Boudreau, in Bourbonnais, IL - Medicare Dietitian, Registered Provider

Jessica Boudreau, is a medicare enrolled "Dietitian, Registered" provider in Bourbonnais, Illinois. Her current practice location is 100 Fitness Dr, Bourbonnais, Illinois. You can reach out to her office (for appointments etc.) via phone at (815) 936-6515.

Jessica Boudreau is licensed to practice in Illinois (license number 164.007714) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1023780673.

Contact Information

	Jessica Boudreau,
	100 Fitness Dr, Bourbonnais, IL 60914-9584
	(815) 936-6515
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Jessica Boudreau
Gender	Female
Speciality	Dietitian, Registered
Location	100 Fitness Dr, Bourbonnais, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1023780673
Provider Enumeration Date: 10/01/2021
Last Update Date: 10/01/2021

Medicare PECOS Information:

PECOS PAC ID: 3971992710
Enrollment ID: I20211116001876

Medical Identifiers

Medical identifiers for Jessica Boudreau such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1023780673	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
133V00000X	Dietitian, Registered	164.007714 (Illinois)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jessica Boudreau allows following entities to bill medicare on her behalf.

Provider Name	Riverside Medical Center
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1982703005 PECOS PAC ID: 5991608549 Enrollment ID: O20040130000202

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jessica Boudreau is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Jessica Boudreau, 100 Fitness Dr, Bourbonnais, IL 60914-9584 Ph: (815) 936-6515	Jessica Boudreau, 100 Fitness Dr, Bourbonnais, IL 60914-9584 Ph: (815) 936-6515

Reviews and Comments

Dietitian, Registered in Bourbonnais, IL

Jeanne Therese Laird, RDN LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 100 Fitness Dr, Bourbonnais, IL 60914 Phone: 815-936-6515 Fax: 815-936-6517
Marcia Krisitin Schultz Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1289 Armour Rd, Bourbonnais, IL 60914 Phone: 815-739-1040
Nicole Potts, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 100 Fitness Dr, Bourbonnais, IL 60914 Phone: 815-936-6515
Isaac Casas, RD, LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 100 Fitness Dr, Bourbonnais, IL 60914 Phone: 815-936-6515 Fax: 815-936-6517
Miss Julie Allen, R.D., L.D.N., C.D.E. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 100 Fitness Dr, Bourbonnais, IL 60914 Phone: 815-936-6515

Jessica Boudreau, - Medicare Dietitian in Bourbonnais, IL