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Organization
BONAFIDE WELLNESS LLC
Active
Organization
BONAFIDE WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BONIFACIO PMHNP-BC (CEO)
(872) 265-1588
Entity
Organization
Contact information
Practice address
213 W INSTITUTE PL STE 500, CHICAGO, IL 60610-8792
(872) 265-1588
Mailing address
2501 CHATHAM RD STE N, SPRINGFIELD, IL 62704-4188
(872) 265-1588
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/29/2026
Last updated
06/07/2026
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