Bousman, Tina M
Bousman, Tina M is an individual health care provider with primary practice located at 4400 W 95Th St Suite 306, Oak Lawn IL 60453-2654. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Bousman, Tina M can be contacted via phone (708) 346-5562.Contact Information
Primary practice address
4400 W 95Th St Suite 306
Oak Lawn IL 60453-2654
Phone: (708) 346-5562
Fax: (708) 346-2059
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 085-002077 | Illinois |
Profile Details
NPI number | 1598751901 |
---|---|
LBN Legal business name | Bousman, Tina M |
Credentials | Physician's Assistant Certified (PA-C) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 21st, 2005 |
Last updated | May 17th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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