Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 036-152434 | IL |
NPI | 1568882157 |
---|---|
Provider Name | Joseph Mcdonald JR. |
First Address | Chicago, IL 60637-1443 |
Second Address | Chicago, IL 60637-1443 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2014 |
Last Update Date | 04/11/2020 |