Healthcare Provider Details

I. General information

NPI: 1154474831
Provider Name (Legal Business Name): PATRICIA LORAINE BOWYER OTR, BCN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3965 75TH ST STE 104
AURORA IL
60504-7913
US

IV. Provider business mailing address

5 WHEATON CTR APT 322
WHEATON IL
60187-4999
US

V. Phone/Fax

Practice location:
  • Phone: 630-236-7000
  • Fax:
Mailing address:
  • Phone: 630-930-4847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: