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General NPI Number Information
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NPI Number | 1033605944
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Entity Type | Individual
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Provider Name | BAO LING PAULINE SOH
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Gender | Female
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Dates
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Enumeration Date | 07/03/2018
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 899 S WEBER RD STE A
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City | BOLINGBROOK
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State | IL
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Zip | 60490-5489
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Country | US
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Telephone | 630-340-1620
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Fax | 331-757-5320
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Provider Business Mailing Address
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Address Line | 899 S WEBER RD STE A
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City | BOLINGBROOK
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State | IL
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Zip | 60490-5489
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085.008418
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License Number State |
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