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Individual

ANDREA L BUKIEWICZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPM, LM

Contact information

Practice address
302 PARK AVE, GRAYSLAKE, IL 60030-2341
(773) 964-6096
Mailing address
302 PARK AVE, GRAYSLAKE, IL 60030-2341
(773) 964-6096

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
119-49
WI

Other

Enumeration date
03/08/2011
Last updated
03/03/2015
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