Individual
AMANDA HUNTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
396 REMINGTON BLVD, SUITE 130, BOLINGBROOK, IL 60440-4302
(630) 759-1248
Mailing address
396 REMINGTON BLVD STE 130, STE 130, BOLINGBROOK, IL 60440-4309
(630) 759-1248
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
85005308
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85005308
STATE LICENSE
IL
Enumeration date
12/12/2014
Last updated
03/09/2016
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