Provider Demographics
NPI:1477190411
Name:BONDE, SIMONE (CNM)
Entity Type:Individual
Prefix:
First Name:SIMONE
Middle Name:
Last Name:BONDE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:757 PARK AVE W STE 2800
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-2557
Mailing Address - Country:US
Mailing Address - Phone:847-941-7600
Mailing Address - Fax:
Practice Address - Street 1:757 PARK AVE W STE 2800
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-2557
Practice Address - Country:US
Practice Address - Phone:847-941-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.020574367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife