Provider Demographics
NPI:1285801803
Name:AHLF, BONNIE KRISTIN (DC)
Entity type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:KRISTIN
Last Name:AHLF
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4405 N DAMEN AVE APT 2N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-8392
Mailing Address - Country:US
Mailing Address - Phone:386-334-7803
Mailing Address - Fax:
Practice Address - Street 1:4405 N DAMEN AVE APT 2N
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-8392
Practice Address - Country:US
Practice Address - Phone:386-334-7803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012674111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor