Bonaventure Medical Foundation

NPI 1083960108 - Clinic/Center - 261QM2500X

NPI Details
NPI 1083960108
Enumeration Date 07/26/2012
Last Updated 07/26/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name MARGARET ROSE MARGARET
Position REG. DIETITIAN/PROGRAM COORDINATOR
Phone (847) 252-6098
Fax
Practice Location
864 W STEARNS RD
SUITE 106
BARTLETT IL, 60103-4800, US
Phone (847) 252-6098
Fax
Business Location
864 W STEARNS RD
SUITE 106
BARTLETT IL, 60103-4800, US
Phone (847) 252-6098
Fax
Toxanomy
Taxonomy Code 261QM2500X
License State Illinois
License Number 164005616
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According to our database, Bonaventure Medical Foundation NPI is 1083960108, taxonomy code is 261QM2500X and license number is 164005616, license state is located at Illinois. Bonaventure Medical Foundation physically located at 864 W Stearns Rd, Bartlett IL, 60103-4800. NPI Number 1033115704 has the healthcare provider type.

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1083960108 NPI number is provided on an as is basis without warranty of any kind. 1083960108 is maintained by the National Plan & Provider Enumeration System. The contents of Bonaventure Medical Foundation are for informational purposes only.