Individual
SHARESE WILSON-BOUIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1490 MERRIMAC LN N, HANOVER PARK, IL 60133-6212
(630) 641-3950
Mailing address
1490 MERRIMAC LN N, HANOVER PARK, IL 60133-6212
(630) 641-3950
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
IL
Other
Enumeration date
11/03/2023
Last updated
11/03/2023
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