Individual
JAMES SCOTT DONALDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
225 E CHICAGO AVE # 9, CHICAGO, IL 60611-2991
(312) 227-3502
(312) 227-9784
Mailing address
225 E CHICAGO AVE #9, ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO, CHICAGO, IL 60611-2991
(312) 227-3502
(312) 227-9784
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
036-070919
IL
2085R0202X
Diagnostic Radiology Physician
Primary
036-070919
IL
2085R0204X
Vascular & Interventional Radiology Physician
036-070919
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021622158
CMMG BLUE SHIELD
IL
05
—
036070919
—
IL
Enumeration date
09/06/2005
Last updated
06/04/2020
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