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Individual

MS. KATHRYN BOUDOURIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, OTR/L

Contact information

Practice address
19100 CRESCENT DR, #101, MOKENA, IL 60448-7510
(708) 478-5400
Mailing address
17064 OLD ORCHARD LN N, LOCKPORT, IL 60441-7412

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.009950
IL

Other

Enumeration date
11/27/2012
Last updated
11/27/2012
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