Bonaventure Medical Foundation

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

164005616 Issued in IL

Legal business name

BONAVENTURE MEDICAL FOUNDATION

Practice address

864 W Stearns Rd
Suite 106
Bartlett, IL 60103-4800

Phone

(847) 252-6098

NPI assigned

Jul 26, 2012

Last updated

Jul 26, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Margaret Rose Connor, R.D., L.D.N.

Title

Reg. Dietitian/Program Coordinator

Phone

(847) 252-6098

Specialties & licenses 1

Addresses

Tax ID family

Bonaventure Med Fndatio2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Bonaventure Medical Foundation, LLC

  dba Alexian Brothers Medical Group

  • Health Educator
  • Schaumburg, IL
  • NPI 1336806736
  NPD tax ID

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/380/brand/1/csg/1/fhir/r4

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343260800000",
    "number": "1083960108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "864 W STEARNS RD",
            "address_2": "SUITE 106",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601034800",
            "telephone_number": "847-252-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "864 W STEARNS RD",
            "address_2": "SUITE 106",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601034800",
            "telephone_number": "847-252-6098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONAVENTURE MEDICAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-26",
        "last_updated": "2012-07-26",
        "status": "A",
        "authorized_official_last_name": "CONNOR",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "REG. DIETITIAN/PROGRAM COORDINATOR",
        "authorized_official_telephone_number": "847-252-6098",
        "authorized_official_credential": "R.D., L.D.N."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IL",
            "license": "164005616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tejas D Bhatt, DR
• Prasad Satya Bhogaraju, P.T.
• Erin Elizabeth Blackburn, LAT, ATC
• Bamini Blau
• Robert Blau
• Allyson Borkowicz, LPC
• Abby Bouldin, ATC
• Michele Branka, MS PT
• Brewster Creek Speech and Language Therapy
• Patricia Brillo, PHARMD.

• Medical Specialty Clinic/Center in Bartlett, IL
• Providers in Bartlett, IL by specialty
• Medical Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.