Individual
MRS. BRENDA ANN BOGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1161 ARDMORE CT, SCHAUMBURG, IL 60193-3630
(847) 534-0892
(630) 237-4454
Mailing address
1161 ARDMORE CT, SCHAUMBURG, IL 60193-3630
(847) 534-0892
(630) 237-4454
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0035640547
BLUE CROSS & BLUE SHIELD
IL
Enumeration date
10/16/2006
Last updated
07/08/2007
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