Individual
MRS. ELLEN JEAN BONINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
40W310 LAFOX RD UNIT A1, ST CHARLES, IL 60175-6591
(630) 444-0077
(630) 444-0078
Mailing address
2956 BASE LINE RD, KIRKLAND, IL 60146-8702
(630) 408-5845
(630) 444-0078
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
IL
Other
Enumeration date
01/23/2007
Last updated
07/08/2007
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