Provider Demographics
NPI:1053832774
Name:BONICK, ANNA M (RN, CD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:M
Last Name:BONICK
Suffix:
Gender:F
Credentials:RN, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 S TAYLOR AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-1620
Mailing Address - Country:US
Mailing Address - Phone:847-494-1436
Mailing Address - Fax:
Practice Address - Street 1:528 S. TAYLOR AVE.
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304
Practice Address - Country:US
Practice Address - Phone:847-494-1436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula