Individual
MRS. DEBORAH JEAN POULOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15232 BUNKER DR, ORLAND PARK, IL 60462-4132
(708) 403-6807
Mailing address
15232 BUNKER DR, ORLAND PARK, IL 60462-4132
(708) 403-6807
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041211246
IL
Other
Enumeration date
04/09/2020
Last updated
04/09/2020
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