Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 036.128362 | IL |
NPI | 1003016585 |
---|---|
Provider Name | Thomas Michael Donahue |
First Address | Chicago, IL 60605-1748 |
Second Address | Chicago, IL 60612-3833 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2007 |
Last Update Date | 10/04/2017 |