| Doctor Name: | ANJENEAN BEHOLD BOLSTER |
| NPI Number: | 1124117122 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN, PNP |
| License Number: | 209010988 |
| Business Practice Address: | 10350 Haligus Rd Huntley, IL - 601429545 |
| Business Phone Number: | 8153386600 |
| Business Fax Number: | 8476692980 |
| Mailing Address: | 10350 Haligus Rd, HUNTLEY |
| State: | IL |
| Postal Code: | 601429545 |
| Phone Number: | 8153386600 |
| Fax Number: | 8476692980 |
| NPI Enumeration Date: | 10/11/2006 |
| NPI Last Update Date: | 04/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 209010988 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |