Individual
GIAN BONADOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
1134 W GRANVILLE AVE APT 715, CHICAGO, IL 60660-5047
(312) 810-3777
Mailing address
1134 W GRANVILLE AVE APT 715, CHICAGO, IL 60660-5047
(312) 810-3777
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.018275
IL
Other
Enumeration date
09/28/2018
Last updated
09/28/2018
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