Individual
BONNIE LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
155 W NORTH AVE, CHICAGO, IL 60610-1314
(872) 221-1211
Mailing address
155 W NORTH AVE, CHICAGO, IL 60610-1314
(872) 221-1211
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070028285
IL
Other
Enumeration date
05/31/2024
Last updated
05/31/2024
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