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NPI Code Detail

MEDICARE: BONNIE TOY

MEDICARE:   BONNIE  TOY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse PractitionerIL

General Provider Information

NPI Number : 1174794689
Entity Type Code : Individual
Provider Name (Legal Business Name) : BONNIE TOY
Provider Business Mailing Address
First Line : 5841 S MARYLAND AVE
Second Line : MC 4060
City : CHICAGO
State : IL
Zip : 60637-1447
Country : US
Telephone Number : 773-702-6808
Fax Number : 773-702-9881
Provider Business Practice Location Address
First Line : 5841 S MARYLAND AVE
Second Line : MC 4060
City : CHICAGO
State : IL
Zip : 60637-1447
Country : US
Telephone Number : 773-702-6808
Fax Number : 773-702-9881
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2008
Last Update Date : 03/12/2008

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Directions to “ BONNIE TOY ” Practice Location

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