Individual
BONNIE BRIANNA ROSE BIERBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1649 N PULASKI RD, CHICAGO, IL 60639-5207
(773) 278-6868
Mailing address
1649 N PULASKI RD, CHICAGO, IL 60639-5207
(737) 278-6868
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085008831
IL
Other
Enumeration date
02/03/2022
Last updated
01/23/2024
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