Individual
MS. JULIE E BONHOTAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
40W803 WILLOWBROOK DR, ST CHARLES, IL 60175-5717
(815) 404-9475
Mailing address
1218 PLEASANT ST, LAKE GENEVA, WI 53147-1044
(815) 404-9475
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004532246
BCBS PROVIDER #
IL
Enumeration date
03/27/2007
Last updated
07/08/2007
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