Individual
MRS. LYNN DE VELDER BOSWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
251 E HURON ST, CHICAGO, IL 60611-2908
(312) 926-7027
Mailing address
3816 PATTY BERG CT, WOODRIDGE, IL 60517-1491
(630) 548-1019
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02232824
PROVIDER NUMBER
IL
Enumeration date
05/06/2007
Last updated
07/08/2007
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