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BONAVENTURE MEDICAL FOUNDATION NPI 1083960108


NPI Profile

NPI: 1083960108
Provider Name: BONAVENTURE MEDICAL FOUNDATION
Classification:Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
864 W STEARNS RD
SUITE 106
BARTLETT, IL
ZIP 60103
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Phone: (847) 252-6098

BONAVENTURE MEDICAL FOUNDATION is a medical specialty clinic center in Bartlett, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). BONAVENTURE MEDICAL FOUNDATION NPI is 1083960108. The provider is registered as an organization entity type.

The provider's business location address is:

864 W STEARNS RD
SUITE 106
BARTLETT, IL
ZIP 60103-800
Phone: (847) 252-6098

The provider's authorized official is Margaret Rose Connor .
The authorized official title is Reg. Dietitian/program Coordinator and has the following contact phone number (847) 252-6098.

The enumeration date for this NPI number is 7/26/2012 and was last updated on 7/26/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM2500XClinic/CenterMedical Specialty164005616ILLINOISYes

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: 6/14/2021

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