Individual
CARLY QUINTEN BONICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5 REVERE DRIVE, ONE NORTHBROOK PLACE SUITE 200, NORTHBROOK, IL 60062-8000
(512) 377-6318
Mailing address
825 N HARVARD AVE, ARLINGTON HEIGHTS, IL 60004-5223
(708) 941-9996
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
1001447229
WI
235Z00000X
Speech-Language Pathologist
1024580
MN
235Z00000X
Speech-Language Pathologist
120561
TX
235Z00000X
Speech-Language Pathologist
Primary
146.016329
IL
235Z00000X
Speech-Language Pathologist
2023006211
MO
235Z00000X
Speech-Language Pathologist
2483958
IL
235Z00000X
Speech-Language Pathologist
6174-154
WI
Other
Enumeration date
12/27/2021
Last updated
06/26/2025
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