Individual
DR. ATHANASIOS BONORIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1726 S ELM ST, DES PLAINES, IL 60018-2216
(847) 824-4873
Mailing address
1726 S ELM ST, DES PLAINES, IL 60018-2216
(847) 824-4873
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036-077564
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01607270
BLUE SHIELD
—
05
—
036077564
—
IL
01
—
110132651
PALMETTO GBA
—
Enumeration date
05/13/2006
Last updated
06/23/2008
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