Individual
ELLISON BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1552 W FULLERTON AVE STE 100, CHICAGO, IL 60614-9018
(773) 270-5600
Mailing address
2 W DELAWARE PL UNIT 1204, CHICAGO, IL 60610-3406
(630) 299-6916
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
150.110672
IL
Other
Enumeration date
05/12/2023
Last updated
05/12/2023
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