Individual
KERRY BOUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11820 WEMBLEY DR, MOKENA, IL 60448-2420
(708) 243-0009
(708) 479-1352
Mailing address
11820 WEMBLEY DR, MOKENA, IL 60448-2420
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Enumeration date
09/28/2008
Last updated
09/28/2008
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