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General NPI Number Information
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NPI Number | 1770937658
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Entity Type | Individual
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Provider Name | JULIA BODNYA
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Gender | Female
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Dates
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Enumeration Date | 04/18/2016
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 5841 S MARYLAND AVE ATTENTION M/C 2030
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City | CHICAGO
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State | IL
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Zip | 60637-1447
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Country | US
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Telephone | 847-312-6559
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Fax |
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Provider Business Mailing Address
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Address Line | 1725 W HARRISON ST STE 885
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City | CHICAGO
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State | IL
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Zip | 60612-3841
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Country | US
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Telephone | 312-942-5939
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 125.068534
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 036151960
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 2084E0001X
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Taxonomy Name | Epilepsy Physician
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License Number | 036151960
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License Number State | IL
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