Joseph P Bonanno, D.O.

Primary specialty

Gynecologic Oncology PhysicianTaxonomy code 207VX0201X

License

036060109 Issued in IL

Practice address

1010 Dixie Hwy Ste 313
Chicago Heights, IL 60411-2666

Phone

(708) 755-2490

Fax

(708) 755-2495

NPI assigned

Mar 21, 2011

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300665600000",
    "number": "1891094546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 DIXIE HWY STE 313",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604112666",
            "telephone_number": "708-755-2490",
            "fax_number": "708-755-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 DIXIE HWY STE 313",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604112666",
            "telephone_number": "708-755-2490",
            "fax_number": "708-755-2495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONANNO",
        "first_name": "JOSEPH",
        "middle_name": "P",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-21",
        "last_updated": "2011-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "IL",
            "license": "036060109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gynecologic Oncology Physician in Chicago Heights, IL
• Providers in Chicago Heights, IL by specialty
• Gynecologic Oncology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2011; 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.