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General NPI Number Information
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NPI Number | 1598901407
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Entity Type | Individual
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Provider Name | BONNIE ANN BURNS LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/23/2008
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Last Update Date | 03/26/2009
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Provider Practice Location Address
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Address Line | 1S302 ARDMORE AVE
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City | VILLA PARK
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State | IL
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Zip | 60181-3707
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Country | US
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Telephone | 630-953-8378
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Fax |
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Provider Business Mailing Address
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Address Line | 1S302 ARDMORE AVENUE
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City | VILLA PARK
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State | IL
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Zip | 60181
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Country | US
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Telephone | 630-953-8378
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.013502
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License Number State | IL
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