Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 036108892 | IL |
NPI | 1154304848 |
---|---|
Provider Name | Aaron Thomas Donnell |
First Address | Chicago, IL 60614-1798 |
Second Address | Chicago, IL 60614-1798 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2005 |
Last Update Date | 31/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036108892 | (05) | IL |
H60015 | (02) |