| Bonilla Psychotherapy Pllc | |
|
5117b Main St Ste 12 Downers Grove IL 60515-4602 | |
| (312) 415-1107 | |
| Not Available |
| Full Name | Bonilla Psychotherapy Pllc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 5117b Main St Ste 12, Downers Grove, Illinois |
| Authorized Official Name and Position | Emma Real Bonilla (OWNER) |
| Authorized Official Contact | 3124151107 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bonilla Psychotherapy Pllc 5117b Main St Ste 12 Downers Grove IL 60515-4602 Ph: (312) 415-1107 | Bonilla Psychotherapy Pllc 5117b Main St Ste 12 Downers Grove IL 60515-4602 Ph: (312) 415-1107 |
| NPI Number | 1013655240 |
|---|---|
| Provider Enumeration Date | 05/26/2022 |
| Last Update Date | 03/03/2023 |
| Certification Date | 03/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013655240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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