Individual
MS. SUSAN MARIE BOOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1315 MARENGO AVE, FOREST PARK, IL 60130-2434
(708) 366-7498
Mailing address
1315 MARENGO AVE, FOREST PARK, IL 60130-2434
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.051922
IL
Other
Enumeration date
05/17/2021
Last updated
05/17/2021
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