Individual
LILIA IVETTE BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1313 W CHICAGO AVE, EAST CHICAGO, IN 46312-3316
(219) 398-9685
(219) 398-9695
Mailing address
2401 VALLEY DR, VALPARAISO, IN 46383-2520
(219) 413-5100
(219) 465-9502
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71001263A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200848650
—
IN
01
—
71001263B
CSR
—
Enumeration date
07/07/2006
Last updated
03/08/2021
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