Individual
DR. CHRISTINA M BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
333 E SUPERIOR ST, CHICAGO, IL 60611-2654
(312) 943-0282
(312) 943-0284
Mailing address
333 E SUPERIOR ST, CHICAGO, IL 60611-2654
(312) 943-0282
(312) 943-0284
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01620273
BLUE CROSS BLUE SHIELD
IL
Enumeration date
07/17/2006
Last updated
07/08/2007
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