Individual
MR. PAUL ROBERT BOONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10300 SOUTHWEST HWY, CHICAGO RIDGE, IL 60415-1426
(708) 425-1100
Mailing address
3600 W 120TH ST APT D302, ALSIP, IL 60803-3673
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057002691
IL
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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