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Individual

MR. JASON MICHAEL BONICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCPC

Contact information

Practice address
7900 DIVISION ST, RIVER FOREST, IL 60305-1066
(708) 524-6946
Mailing address
7900 DIVISION ST, RIVER FOREST, IL 60305-1066

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180005128
IL

Other

Enumeration date
06/19/2008
Last updated
06/19/2008
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