Provider Demographics
NPI:1902018732
Name:LITOWITZ, BONNIE ELLENBOGEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:ELLENBOGEN
Last Name:LITOWITZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 E CHICAGO AVENUE
Mailing Address - Street 2:46E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-6680
Mailing Address - Country:US
Mailing Address - Phone:312-951-6310
Mailing Address - Fax:312-751-9525
Practice Address - Street 1:180 NORTH MICHIGAN AVENUE
Practice Address - Street 2:SUITE 2220
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7478
Practice Address - Country:US
Practice Address - Phone:312-759-8130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL400103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis