Individual
STACEY BETHUNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2222
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
096.003703
IL
Other
Enumeration date
05/15/2014
Last updated
05/15/2014
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