Individual
JEAN E BOURAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5025 W FULLERTON AVE, CHICAGO, IL 60639
(773) 622-6955
(773) 622-6989
Mailing address
5025 W FULLERTON AVE, CHICAGO, IL 60639
(773) 622-6955
(773) 622-6989
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36065922
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31600851
BCBS
—
Enumeration date
09/13/2006
Last updated
02/03/2012
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