Provider Demographics
NPI:1083096127
Name:BOSE, AMANDA LYNN (DC, ND, MS)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:LYNN
Last Name:BOSE
Suffix:
Gender:F
Credentials:DC, ND, MS
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:LYNN
Other - Last Name:PANUSKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC, ND, MS
Mailing Address - Street 1:890 E HIGGINS RD STE 150E
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4749
Mailing Address - Country:US
Mailing Address - Phone:630-506-8318
Mailing Address - Fax:630-506-8318
Practice Address - Street 1:890 E HIGGINS RD STE 150E
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4749
Practice Address - Country:US
Practice Address - Phone:630-506-8318
Practice Address - Fax:630-506-8318
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175F00000X
IL038012737111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No175F00000XOther Service ProvidersNaturopath