Individual
MRS. LINDA GEORGETTE BOULWARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2045 W GRAND AVE STE B, CHICAGO, IL 60612-1577
(888) 660-4425
Mailing address
1591 ABBOTT ST, CARLYLE, IL 62231-1107
(618) 741-8431
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.022606
IL
Other
Enumeration date
01/08/2021
Last updated
01/08/2021
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