# BONAVENTURE MEDICAL FOUNDATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083960108
- **Authorized official:** MARGARET ROSE CONNOR R.D., L.D.N. (REG. DIETITIAN/PROGRAM COORDINATOR)
- **Authorized official phone:** (847) 252-6098

## Contact information

- **Practice address:** 864 W STEARNS RD, SUITE 106, BARTLETT, IL 60103-4800
- **Practice address phone:** (847) 252-6098
- **Mailing address:** 864 W STEARNS RD, SUITE 106, BARTLETT, IL 60103-4800
- **Mailing address phone:** (847) 252-6098

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 164005616 | IL | Yes |

## Other

- **Enumeration date:** 07/26/2012
- **Last updated:** 07/26/2012