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Individual

MARCO BONILLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MEDICINE DOCTOR

Contact information

Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(773) 702-1000
Mailing address
150 HARVESTER DR STE 300, BURR RIDGE, IL 60527-5965
(773) 702-1150

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036159902
IL
207RN0300X
Nephrology Physician
305527
NY

Other

Enumeration date
05/12/2017
Last updated
08/05/2022
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