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Individual
ROBERT A BONZANI
Active
Individual
ROBERT A BONZANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
03609775
IL
208800000X
Urology Physician
01078104A
IN
208800000X
Urology Physician
12014
ND
208800000X
Urology Physician
Primary
91544
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036097795
—
IL
05
—
16290
—
ND
01
—
5642652
AETNA PROVIDER NUMBER
IL
01
—
964290012
PRNGRSMTH MEDICARE PTAN
IL
Enumeration date
06/14/2005
Last updated
05/06/2025
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