Individual
KATHLEEN M BOEHMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
319 FRONT ST, MCHENRY, IL 60050-5504
(815) 578-9655
(815) 578-9642
Mailing address
319 FRONT ST, MCHENRY, IL 60050-5504
(815) 578-9655
(815) 578-9642
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05632057
BLUE CROSS BLUE SHIELD
IL
01
—
7515430
AETNA
IL
Enumeration date
11/27/2007
Last updated
11/27/2007
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