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Individual
ANNE M DONNELLY
Active
Individual
ANNE M DONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036083387
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
920540
MEDICARE PTAN (GROUP)
IL
01
—
F400268425
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
06/08/2006
Last updated
01/26/2016
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