Individual
GRACE BONASERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
3709 N KEDZIE AVE, CHICAGO, IL 60618-4503
(773) 377-5492
Mailing address
3709 N KEDZIE AVE, CHICAGO, IL 60618-4503
(773) 377-5492
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242.004753
IL
Other
Enumeration date
04/14/2019
Last updated
04/14/2019
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