Healthcare Provider Details

I. General information

NPI: 1366190019
Provider Name (Legal Business Name): VERONIKA BILONIC FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2022
Last Update Date: 12/15/2022
Certification Date: 12/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 1ST AVE
LYONS IL
60534-1028
US

IV. Provider business mailing address

29373 NETWORK PL
CHICAGO IL
60673-1028
US

V. Phone/Fax

Practice location:
  • Phone: 708-447-6851
  • Fax:
Mailing address:
  • Phone: 847-390-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209021383
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: