Individual ProviderDavide BovaRadiologyAllopathic & Osteopathic PhysiciansPractice Address2160 S First Ave, 101 1740 Loyola University Medical Center, Maywood, IL 60153(708) 216-9000PECOS EnrollmentBased on the most recent information from CMS, provider Davide Bova is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 7 days ago.Profile DetailsProvider ID1346227212Provider TypeIndividualFull NameBova, DavideCredentialMDGenderMaleSole ProprietorYesEnumeration Date12/30/2005Last Updated5/16/2022Contact InformationPractice LocationPractice Address2160 S First Ave, 101 1740 Loyola University Medical Center, Maywood, IL 60153Phone(708) 216-9000Fax(708) 216-9033Mailing LocationMailing Address2160 S First Ave, 101 1740 Loyola University Medical Center, Maywood, IL 60153PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode2085R0202XPrimaryDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicense36097530IllinoisProvider IdentifiersIDDescriptionIssuerID36097530DescriptionMedicaidIssuerUnlistedIllinois