Individual
DONNA D VAN DAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN/CNM
Contact information
Practice address
720 BROM CT, SUITE 104, NAPERVILLE, IL 60540-6531
(630) 717-9977
(630) 717-6267
Mailing address
720 BROM CT, SUITE 104, NAPERVILLE, IL 60540-6531
(630) 717-9977
(630) 717-6267
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
309.000811
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21605044
BLUE CROSS BLUE SHIELD
IL
Enumeration date
02/28/2012
Last updated
02/28/2012
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