Individual
MISS COURTNEY MARGARET DE SOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1300 N OAKLAND AVE, BOLIVAR, MO 65613-3042
(417) 326-7676
Mailing address
5140 N CALIFORNIA AVE, CHICAGO, IL 60625
(773) 878-2000
(773) 293-5670
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
12507687
IL
207Q00000X
Family Medicine Physician
Primary
2023026723
MO
Other
Enumeration date
06/17/2020
Last updated
01/13/2026
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