Individual
ASHLEY ERIN BOUMGARDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14 LAKE ST, OAK PARK, IL 60302-2606
(708) 383-0113
Mailing address
1022 S SCOVILLE AVE, OAK PARK, IL 60304-2128
(630) 913-1195
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041462308
IL
363LF0000X
Family Nurse Practitioner
Primary
209030519
IL
Other
Enumeration date
04/16/2024
Last updated
10/28/2024
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