Provider Demographics
NPI:1497036289
Name:BOSHER, ANN-PRESTON (DPT)
Entity Type:Individual
Prefix:
First Name:ANN-PRESTON
Middle Name:
Last Name:BOSHER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 LEXINGTON DR
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60192-1826
Mailing Address - Country:US
Mailing Address - Phone:847-902-6831
Mailing Address - Fax:
Practice Address - Street 1:1815 S WOLF RD
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:IL
Practice Address - Zip Code:60162-2110
Practice Address - Country:US
Practice Address - Phone:708-236-0979
Practice Address - Fax:708-236-5161
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-07
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.018593225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist