Patricia M O'donnell
Podiatrist
885 Roosevelt Rd
Glen Ellyn
, Illinois 60137-6141
Patricia M O'donnell
Podiatrist
885 Roosevelt Rd
Glen Ellyn
, Illinois 60137-6141
(630) 225-2399
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About
Features
Specialties
- Podiatrist
Languages spoken
- English
Location
First Address
- Patricia M O'donnell
- 885 Roosevelt Rd
- Glen Ellyn, IL
- Zip : 60137-6141
- Fax : (630) 225-2399
- Phone : (630) 225-2663
Second Address
- Patricia M O'donnell
- 885 Roosevelt Rd
- Glen Ellyn, IL
- Zip : 60137-6141
- Fax : (630) 225-2399
- Phone : (630) 225-2663
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 0016004785 | IL |
| Y | 222Z00000X | Podiatrist | 0016004785 | IL |
National Provider Identifier
| NPI | 1013047190 |
|---|---|
| Provider Name | Patricia M O'donnell |
| First Address | Glen Ellyn, IL 60137-6141 |
| Second Address | Glen Ellyn, IL 60137-6141 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/03/2007 |
| Last Update Date | 05/05/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 016004785 | MEDICAID (01) | IL |
| 206147 | MEDICARE PTAN (GROUP) (01) | IL |
| F400181111 | MEDICARE PTAN (INDIVIDUAL) (01) | IL |
| U62306 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.