Individual
KATHLEEN BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 ROHLWING RD, ELK GROVE VLG, IL 60007-3217
(224) 213-0012
Mailing address
712 N MAIN ST, MOUNT PROSPECT, IL 60056-2115
(224) 213-0012
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041.500667
IL
Other
Enumeration date
11/25/2020
Last updated
11/25/2020
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