Lady Bowennesheim

NPI 1790175826 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1790175826
Gender Female
Enumeration Date 01/27/2015
Last Updated 01/27/2015
Entity Type Individual
Active Over 1 year ago
Practice Location
431 W LIBERTY ST
WAUCONDA IL, 60084-2452, US
Phone (847) 526-2151
Fax
Business Location
2125 S TONNE DR APT 122
ARLINGTON HEIGHTS IL, 60005-4125, US
Phone (630) 486-2338
Fax
Toxanomy
Taxonomy Code 363LF0000X
License State Illinois
License Number 209.012098
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According to our database, Lady Bowennesheim NPI is 1790175826, taxonomy code is 363LF0000X and license number is 209.012098, license state is located at Illinois. Lady Bowennesheim physically located at 431 W Liberty St, Wauconda IL, 60084-2452. NPI Number Lady Bowennesheim has the Individual type.

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1790175826 NPI number is provided on an as is basis without warranty of any kind. 1790175826 is maintained by the National Plan & Provider Enumeration System. The contents of Lady Bowennesheim are for informational purposes only.