LADY BOWENNESHEIM

WAUCONDA, IL
NPI1790175826
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IL  209.012098)
Enumeration Date2015-01-27
Last Update Date2019-12-09
Business Address
LADY BOWENNESHEIM
431 W LIBERTY ST
WAUCONDA, IL 60084-2452
Phone number: 847-526-2151
Mailing Address
LADY BOWENNESHEIM
PO BOX 6037
WAUCONDA, IL 60084-6037
Phone number: 847-526-2151
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