Individual
LARA KATHLEEN BONASERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
836 W WELLINGTON AVE, CHICAGO, IL 60657-5147
(773) 975-1600
Mailing address
2334 MOMENTUM PL, CHICAGO, IL 60689-5325
(224) 231-4363
(866) 642-1525
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036106687
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036106687
—
IL
Enumeration date
06/23/2006
Last updated
05/16/2025
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