Tina Bousman, PA-C

NPI 1598751901 · on the registry since 2005

Practice

Address: 4400 W 95th St
Suite 306
Oak Lawn, IL 60453
Phone: (708) 346-5562
Fax: (708) 346-2059
Organisation at this address: Susan C Apolinario
V Upadhyaya Md Ltd
Md Pediatric Center
Vanessa Hagan, Md, Sc
Gavani & Kanuri Md Sc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 197

Registry record

Primary taxonomy: 363AM0700X
363AM0700X
Licence states on file: IL
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2010-05-17

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois