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Mr. Emmanuel Boutcheko
Licensed Practical Nurse in Lansing, Illinois
NPI 1942731922

Emmanuel Boutcheko is a Licensed Practical Nurse based in Lansing, IL. Emmanuel Boutcheko practices in Lansing, IL. The NPI Number for Emmanuel Boutcheko is 1942731922 and holds a License No. 043.105922 (Illinois).

The current practice location address for Emmanuel Boutcheko is 17709 William St, Lansing, IL and can be reached out via phone at 708-307-3854.

Location: 17709 William St, Lansing, IL, 60438-2063
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1942731922
Provider Name
Emmanuel Boutcheko
Credential
Provider Entity Type
Individual
Gender
Male
Address
17709 William St, Lansing, IL, 60438-2063
Phone Number
708-307-3854
Fax Number
Provider Enumeration Date
03/22/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
043.105922 01 IL LICENSE PRACTICAL NURSE
institution
Provider Business Practice Location Address Details
Address
17709 William St
City
Lansing
State
Illinois
Zip
60438-2063
Phone Number
708-307-3854
Fax Number
person
Provider Business Mailing Address Details
Address
17709 William St
City
Lansing
State
Illinois
Zip
60438-2063
Phone Number
708-307-3854
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Practical Nurse
Speciality
-
Taxonomy
164W00000X
License No.
043.105922 (Illinois)
Definition
An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
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