Michael G Bonifacio, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

277005466 Issued in IL

Practice address

2918 W Logan Blvd
Chicago, IL 60647-1732

Phone

(773) 817-2577

NPI assigned

Sep 13, 2023

Last updated

Apr 20, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baal Perazim Wellness IncGroup PAC ID 7618218587, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Baal Perazim Wellness, Inc

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1215403530
  Medicare reassignment Care Compare group NPD
• Edgewood Clinical Services, P.C.

  dba LifeStance

  • Psychologist
  • Naperville, IL
  • NPI 1295914646

  Psychiatric/Mental Health

  Medicare reassignment NPD
• The Ruth Institute of Integrative Care LLC

  • Psychiatry Physician
  • Northbrook, IL
  • NPI 1538745153
  Medicare reassignment NPD
• Bonafide Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
  • NPI 1508703414
  NPD Authorized official
• Beth Psychiatry LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Frankfort, IL
  • NPI 1063193829
  NPD (past)
• Psychology Specialists LTD

  dba LifeStance Health

  • Clinical Psychologist
  • Bloomington, IL
  • NPI 1053368605
  NPD (past)

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1275310146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2918 W LOGAN BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471732",
            "telephone_number": "773-817-2577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2918 W LOGAN BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471732",
            "telephone_number": "773-817-2577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONIFACIO",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-13",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "277005466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonfire Clinical Services
• Lindsey Allison Bongiorno
• Kathryn Elizabeth Bongiovanni, MA, LCSW, CADC
• Vanessa Joy Bongiovanni, LCSW
• Cara Bonick
• Ramon Bonifacio, APN, PMHNP-BC
• Aniyah Jessica Bonilla
• Jessica Bonilla
• Marco Bonilla, MEDICINE DOCTOR
• Suleima Bonilla, M.A., BCBA

• Psychiatric/Mental Health Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.