Individual
BONAVENTURE I OGU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4554 N BROADWAY ST STE 218, CHICAGO, IL 60640-5671
(773) 554-2490
Mailing address
1906 LEE ST, EVANSTON, IL 60202-1537
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2025086017
IL
Other
Enumeration date
01/27/2026
Last updated
03/11/2026
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