PORTIA BONEBRAKE (NPI# 1073673760) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073673760 |
| Entity Type | Individual |
| Full Name | PORTIA BONEBRAKE |
| Credential | M.D. |
| Practice Address |
2542 W North Ave Chicago IL 60647-5216 |
| Practice Telephone | 7733657277 |
| Practice Fax Number | 7733653091 |
| Mailing Telephone | 7733657277 |
| Mailing Fax Number | 7733653091 |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2008-10-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
036-112602 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | STATE LICENSE NUMBER | 036-112602 | 01 |
| IL | 036112602 | 05 | |
| BLUE SHIELD | 036112602 | 01 |
| Street Address |
2542 W NORTH AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60647-5216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750395786 | Victoria Pape | Counselor | 2542 W North Ave, Chicago, IL 60647-5216 | 2006-07-27 |
| 1942808290 | Rachel Kristi Ourada | Social Worker | 2542 W North Ave, Chicago, IL 60647-5216 | 2020-10-09 |
| 1477025385 | Lauren Mosley | Social Worker | 2542 W North Ave, Chicago, IL 60647-5216 | 2018-12-18 |
| 1720573454 | Arlyn Marisa Bateman | Marriage & Family Therapist | 2542 W North Ave, Chicago, IL 60647-5216 | 2018-06-26 |
| 1407384464 | Elizabeth R Tulsky | Social Worker | 2542 W North Ave, Chicago, IL 60647-5216 | 2017-06-02 |
| 1942740055 | Celeste Richards Bonanno | Social Worker | 2542 W North Ave, Chicago, IL 60647-5216 | 2017-03-08 |
| 1811430416 | Elizabeth Petruzzi | Counselor | 2542 W North Ave, Chicago, IL 60647-5216 | 2016-11-30 |
| 1194268144 | Ryan Catania | Social Worker | 2542 W North Ave, Chicago, IL 60647-5216 | 2016-11-23 |
| 1649626854 | Madeline Macy Root | Social Worker | 2542 W North Ave, Chicago, IL 60647-5216 | 2016-05-05 |
| 1063872695 | Rebecca Claire Bobrow | Social Worker | 2542 W North Ave, Chicago, IL 60647-5216 | 2016-02-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164035879 | Scott Spine and Health LLC | Chiropractor | 2560 W. Armitage Ave, Unit C2, Chicago, IL 60647 | 2020-08-24 |
| 1003424458 | Emily Gleesing | Physical Therapist | 1923 N Western Ave, Chicago, IL 60647 | 2020-07-21 |
| 1699301358 | Marcella Guzman P.C. | Dentist | 3236 W. Fullerton Ave., Chicago, IL 60647 | 2020-03-13 |
| 1740772342 | Envision Unlimited | Case Management | 2646 N Washtenaw Ave # 3n, Chicago, IL 60647 | 2018-05-31 |
| 1992297535 | Envision Unlimited | Case Management | 2646 N Washtenaw Ave # 2n, Chicago, IL 60647 | 2018-05-30 |
| 1942704580 | Team Rehabilitation Il15, LLC | Physical Therapist | 1923 N Western Avenue, Chicago, IL 60647 | 2018-03-20 |
| 1023517331 | Chicago Medical Healthcare Group, S.c. | Family Medicine | 3648 W Armitage Avenue, Chicago, IL 60647 | 2018-02-02 |
| 1023537693 | Erin Frommeyer | Physician Assistant | 2228 W Dickens Avenue, Chicago, IL 60647 | 2017-09-15 |
| 1457872475 | Stefanie Paola Maurtua | Behavioral Analyst | 2448 West Bloomingdale Ave., Apt 2e, Chicago, IL 60647 | 2017-06-29 |
| 1700322922 | Lumen Optical Illinois 4, LLC | Optometrist | 2420 N Elston, Bucktown, IL 60647 | 2017-01-11 |
| Find all providers in zip 60647 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144848086 | Zachary A Kordik Md PC | Psychiatry & Neurology | 25 E Washington St Ste 904, Chicago, IL 60602-1715 | 2020-07-07 |
| 1659996767 | Bluesky Telepsych | Psychiatry & Neurology | 4753 N Broadway St Ste 910, Chicago, IL 60640-4991 | 2020-06-15 |
| 1164047833 | Advanced Psychiatry Clinics, S.c. | Psychiatry & Neurology | 5519 N Cumberland Ave Ste 1016, Chicago, IL 60656-1480 | 2020-06-09 |
| 1326661802 | Psychmed Clinic Inc | Psychiatry & Neurology | 2159 W Madison St, Chicago, IL 60612-2307 | 2020-05-19 |
| 1467074534 | Holmes Psychiatry LLC | Psychiatry & Neurology | 2027 W Division St # 144, Chicago, IL 60622-9024 | 2020-05-12 |
| 1952937104 | Bespoke Psychiatry | Psychiatry & Neurology | 727 W Madison St Apt 4302, Chicago, IL 60661-2580 | 2020-03-19 |
| 1588295125 | Chicago Psychiatric Partners LLC | Psychiatry & Neurology | 625 N Michigan Ave Ste 1910, Chicago, IL 60611-3178 | 2020-02-03 |
| 1841758646 | River North Psychiatry LLC | Psychiatry & Neurology | 405 N Wabash Ave Unit 3209, Chicago, IL 60611-5675 | 2019-03-11 |
| 1760952865 | Mandy Evans, Md, LLC | Psychiatry & Neurology | 2421 N Lawndale Ave, Chicago, IL 60647-2320 | 2018-11-30 |
| 1841773074 | Musec Medical LLC | Psychiatry & Neurology | 1520 W Walton St Unit 3, Chicago, IL 60642-5212 | 2018-09-13 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.