Individual
ALYSSA JOY BOLDUAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
302 RANDALL RD STE 202, GENEVA, IL 60134-4204
(630) 938-3900
(630) 938-3910
Mailing address
302 RANDALL RD STE 202, GENEVA, IL 60134-4204
(630) 938-3900
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
036156561
IL
207Y00000X
Otolaryngology Physician
60967
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2015
Last updated
04/29/2022
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