Amy Lenee Bonilla PA-C

NPI 1477783736 - Physician Assistant - 363A00000X

NPI Details
NPI 1477783736
Gender Female
Enumeration Date 07/21/2009
Last Updated 07/21/2009
Entity Type Individual
Active Over 7 years ago
Practice Location
2800 S CALIFORNIA AVE
CHICAGO IL, 60608-5107, US
Phone (773) 869-5468
Fax (773) 869-3578
Business Location
2800 S CALIFORNIA AVE
CHICAGO IL, 60608-5107, US
Phone (773) 869-5468
Fax (773) 869-3578
Toxanomy
Taxonomy Code 363A00000X
License State Illinois
License Number 085003412
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According to our database, Mrs. Amy Lenee Bonilla PA-C NPI is 1477783736, taxonomy code is 363A00000X and license number is 085003412, license state is located at Illinois. Amy Lenee Bonilla PA-C physically located at 2800 S California Ave, Chicago IL, 60608-5107. NPI Number Amy Lenee Bonilla PA-C has the Individual type.

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1477783736 NPI number is provided on an as is basis without warranty of any kind. 1477783736 is maintained by the National Plan & Provider Enumeration System. The contents of Amy Lenee Bonilla PA-C are for informational purposes only.