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NPI Code Detail

MEDICARE: JESSICA BONAGURO LCSW

MEDICARE: JESSICA BONAGURO LCSW
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
11041C0700XClinical Social Worker149029990IL

General Provider Information

NPI Number : 1326991704
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA BONAGURO LCSW
Provider Business Mailing Address
First Line : 111 W JACKSON BLVD STE 1700
Second Line :
City : CHICAGO
State : IL
Zip : 60604-3597
Country : US
Telephone Number : 646-941-7645
Fax Number : 929-596-7897
Provider Business Practice Location Address
First Line : 111 W JACKSON BLVD STE 1700
Second Line :
City : CHICAGO
State : IL
Zip : 60604-3597
Country : US
Telephone Number : 646-941-7645
Fax Number : 929-596-7897
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2026
Last Update Date : 02/17/2026

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Directions to “ JESSICA BONAGURO LCSW” Practice Location

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