Individual
DR. BONNIE J VASTOLA-LEWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2500 W FABYAN PKWY, BATAVIA, IL 60510-1572
(630) 879-2110
Mailing address
2357 SEQUOIA DR, AURORA, IL 60506-6222
(630) 859-6800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-123825
IL
207Q00000X
Family Medicine Physician
125049895
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036123825
—
IL
01
—
04515143
BCBS #
IL
Enumeration date
05/31/2008
Last updated
11/18/2021
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