Individual
MR. JULIUS P. BONELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 MAIN STREET, SUITE 300, PEORIA, IL 61606
(309) 495-0200
(309) 676-6545
Mailing address
1001 MAIN STREET, SUITE 300, PEORIA, IL 61606
(309) 495-0200
(309) 676-6545
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036058876-1
IL
208C00000X
Colon & Rectal Surgery Physician
036058876
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036058876-1
—
IL
01
—
7215166
BCBS
IL
Enumeration date
06/22/2006
Last updated
02/01/2013
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