Healthcare Provider Details

I. General information

NPI: 1740185883
Provider Name (Legal Business Name): STEFANIE BONNELL LCSW, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1039 KENTON RD
DEERFIELD IL
60015-3305
US

IV. Provider business mailing address

PO BOX 10868
CHICAGO IL
60610-0868
US

V. Phone/Fax

Practice location:
  • Phone: 312-834-3054
  • Fax:
Mailing address:
  • Phone: 312-834-3054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: STEFANIE BONNELL
Title or Position: OWNER
Credential: LCSW
Phone: 312-834-3054