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1316012537
MICHAEL R BOURBON
VERNON HILLS, IL
NPI
1316012537
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149007084)
Enumeration Date
2006-11-22
Last Update Date
2007-07-08
Business Address
-- MICHAEL R BOURBON LCSW
977 LAKEVIEW PKWY # 155
VERNON HILLS, IL 60061-1400
Phone number: 847-918-0129
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Mailing Address
-- MICHAEL R BOURBON LCSW
977 LAKEVIEW PKWY # 155
VERNON HILLS, IL 60061-1400
Phone number: 847-918-0129
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