PORTIA BONEBRAKE M.D. NPI 1073673760

NPI Information

NPI: 1073673760
Provider Name: PORTIA BONEBRAKE, M.D.
Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Individual

Specialization: Psychiatry

Address:
2542 W NORTH AVE
CHICAGO, IL
ZIP 60647
Phone: (773) 365-7277
Get Directions

Portia Bonebrake, M.D. is a psychiatry psychiatry neurology in Chicago, IL. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. Portia Bonebrake, M.D. NPI is 1073673760. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2542 W NORTH AVE
CHICAGO, IL
ZIP 60647-216
Phone: (773) 365-7277
Fax: (773) 365-3091

The enumeration date for this NPI number is 12/11/2006 and was last updated on 10/28/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084P0800X	Psychiatry & Neurology	Psychiatry	036-112602	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	036112602	OTHER		BLUE SHIELD
2	K40152	MEDICARE PIN
3	036-112602	OTHER	ILLINOIS	STATE LICENSE NUMBER
4	036112602	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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