Individual
MS. MERIEM ELSAYED BOUFETTA I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
5024 W WINONA ST APT 2, CHICAGO, IL 60630-2318
(773) 818-1875
Mailing address
5024 W WINONA ST APT 2, CHICAGO, IL 60630-2318
(773) 818-1875
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
15476524
IL
Other
Enumeration date
11/25/2024
Last updated
11/25/2024
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