MEDICARE: J BONSOL & COMPANY

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
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1922665728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J BONSOL & COMPANY

Provider Business Mailing Address
First Line	:	1841 S CALUMET AVE APT 1508
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616-4817
Country	:	US
Telephone Number	:	310-963-5220
Fax Number	:

Provider Business Practice Location Address
First Line	:	4753 N BROADWAY ST STE 401
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-4981
Country	:	US
Telephone Number	:	312-588-6901
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. MICHAEL JEREMY D BONSOL
Credential	:	DC
Telephone Number	:	312-588-6901

Provider Enumeration Date	:	05/28/2019
Last Update Date	:	01/28/2025

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