Individual
DIANE BOQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2674 WASHINGTON ST, WAUKEGAN, IL 60085-4917
(847) 336-8089
(847) 336-8079
Mailing address
625 ENTERPRISE DR, OAK BROOK, IL 60523-8813
(630) 575-1980
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.020983
IL
Other
Enumeration date
10/09/2014
Last updated
10/12/2017
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