Individual
MRS. PAMELA BEAUDUY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1901 W HARRISON ST, CHICAGO, IL 60612-3714
(773) 854-3827
(773) 854-3826
Mailing address
233 RIVERSIDE DR, DOLTON, IL 60419-1430
(708) 201-8059
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3007037
EMPLOYMENT BADGE NUMBER
IL
Enumeration date
04/04/2007
Last updated
07/08/2007
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