Individual
MR. WALTER ALAN MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
400 N CALDWELL ST, STAUNTON, IL 62088-1423
(618) 635-2200
Mailing address
16280 INDIAN LAKE RD, JERSEYVILLE, IL 62052-7017
(618) 885-5548
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209002824
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209002824
C.R.N.A. LICENSE NUMBER
IL
Enumeration date
11/15/2006
Last updated
07/08/2007
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