Individual
JACQUELYN BURKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
722 LENOX AVE, BOLINGBROOK, IL 60490-4986
(630) 862-6331
Mailing address
722 LENOX AVE, BOLINGBROOK, IL 60490-4986
(630) 862-6331
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041435415
IL
Other
Enumeration date
04/03/2019
Last updated
04/03/2019
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