Active NPI
Michelle M Bonavolonta, OT
- Occupational Therapist
- Warrenville, IL
National Provider Identifier
1669428801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056-000708
- Practice address
- 27650 Ferry Rd
Suite 100
Warrenville, IL 60555-3845 - Phone
- (630) 225-2663
- Fax
- (630) 225-2399
- NPI assigned
- May 26, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056-000708 | IL | Primary |
Addresses
Primary practice location
27650 Ferry Rd
Suite 100
Warrenville, IL 60555-3845
Mailing address
27650 Ferry Rd
Suite 100
Warrenville, IL 60555-3845
Phone (630) 225-2663
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01185607 | Other | IL | RR MEDICARE |
Other names 1
- Michelle M Gojda
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056-000708 | IL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oad Orthopaedics, LTD | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
- Warrenville, IL
- NPI 1801844642
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403481600000",
"number": "1669428801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27650 FERRY RD",
"address_2": "SUITE 100",
"city": "WARRENVILLE",
"state": "IL",
"postal_code": "605553845",
"telephone_number": "630-225-2663",
"fax_number": "630-225-2399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27650 FERRY RD",
"address_2": "SUITE 100",
"city": "WARRENVILLE",
"state": "IL",
"postal_code": "605553845",
"telephone_number": "630-225-2663",
"fax_number": "630-225-2399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONAVOLONTA",
"first_name": "MICHELLE",
"middle_name": "M",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-26",
"last_updated": "2014-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056-000708",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P01185607",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MICHELLE",
"last_name": "GOJDA",
"middle_name": "M",
"credential": "OT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Warrenville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.