Individual
DOROTHY BOURGEOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
701 LEE ST STE 800, DES PLAINES, IL 60016-4550
(847) 795-3951
Mailing address
1021 N MULFORD RD, ROCKFORD, IL 61107-3877
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
041244932
IL
Other
Enumeration date
12/18/2018
Last updated
12/18/2018
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