Most Relevant Information
Provider Data
| NPI Number: | 1003551672 |
| Provider Name: | MATTHEW BONOMO MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/28/2022 |
| Last Updated: | 06/25/2022 |
Provider Practice Location
5841 S. MARYLAND AVE.
M/C 5068
CHICAGO
IL
606371443
Practice Location Phone/Fax
| Phone: | 7737029109 |
| Fax: | 7737023135 |
Provider Mailing Location
150 HARVESTER DR. STE 300
BURR RIDGE
IL
605276686
Provider Mailing Phone/Fax
| Phone: | 7737021150 |
| Fax: |