Pamela Kay Bonjean
Individual provider Active NPI Contractor · Springfield, IL
NPI 1740468297 · NPPES record last updated Feb 7, 2008
Key facts
- NPI
- 1740468297
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 535 W Canedy St
Springfield, IL 62704-2728 - Phone
- (217) 525-4013
- NPI assigned
- Feb 7, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Yes |
Addresses
Primary practice location
535 W Canedy St
Springfield, IL 62704-2728
Mailing address
535 W Canedy St
Springfield, IL 62704-2728
Phone (217) 525-4013
Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.