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General NPI Number Information
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NPI Number | 1922665728
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Entity Type | Organization
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Legal Business Name | J BONSOL & COMPANY
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Dates
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Enumeration Date | 05/28/2019
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 4753 N BROADWAY ST STE 401
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City | CHICAGO
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State | IL
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Zip | 60640-4981
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Country | US
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Telephone | 312-588-6901
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Fax |
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Provider Business Mailing Address
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Address Line | 1841 S CALUMET AVE APT 1508
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City | CHICAGO
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State | IL
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Zip | 60616-4817
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Country | US
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Telephone | 310-963-5220
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. MICHAEL JEREMY D BONSOL
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Credential | DC
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Telephone | 312-588-6901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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