Individual
THERESE MARIE BOLGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
4255 W 63RD ST, CHICAGO, IL 60629-5041
(773) 424-4048
(773) 424-6463
Mailing address
4255 W 63RD ST, CHICAGO, IL 60629-5041
(773) 424-4048
(773) 424-6463
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085.004226
IL
Other
Enumeration date
03/01/2012
Last updated
05/07/2019
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