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NPI Code Detail

MEDICARE: BONNIE CARE MEDICAL RESOURCES, LLC.

MEDICARE: BONNIE CARE MEDICAL RESOURCES, LLC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies203000907IL

General Provider Information

NPI Number : 1912020686
Entity Type Code : Organization
Provider Name (Legal Business Name) : BONNIE CARE MEDICAL RESOURCES, LLC.
Provider Business Mailing Address
First Line : 3413 N MILWAUKEE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60641-4040
Country : US
Telephone Number : 773-353-5061
Fax Number : 773-249-4012
Provider Business Practice Location Address
First Line : 3413 N MILWAUKEE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60641-4040
Country : US
Telephone Number : 773-353-5061
Fax Number : 773-249-4012
Authorized Official
Title or Position : PRESIDENT
Name : MRS. BONITA R VILLAR
Credential : R.N.
Telephone Number : 773-353-5061
Provider Enumeration Date : 04/09/2007
Last Update Date : 03/04/2010

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Directions to “BONNIE CARE MEDICAL RESOURCES, LLC. ” Practice Location

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