Provider Demographics
NPI:1710866454
Name:BONOW, SAMUEL CRAWFORD (DPT)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:CRAWFORD
Last Name:BONOW
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7447 N CLARK ST STE B107
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-1619
Mailing Address - Country:US
Mailing Address - Phone:224-273-6590
Mailing Address - Fax:
Practice Address - Street 1:7447 N CLARK ST STE B107
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-1619
Practice Address - Country:US
Practice Address - Phone:224-273-6590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-28
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.029431225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist