Provider Demographics
NPI:1073043311
Name:BOSCO, ABIGAIL S
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:S
Last Name:BOSCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:S
Other - Last Name:BOSCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ABIGAIL BOSCO
Mailing Address - Street 1:2258 NICHOLS RD APT D
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-1143
Mailing Address - Country:US
Mailing Address - Phone:773-849-3412
Mailing Address - Fax:
Practice Address - Street 1:1845 GRANDSTAND PL
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-6603
Practice Address - Country:US
Practice Address - Phone:847-695-0484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health