Individual
PATRICK GILBERT O'DONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1945 S SPRING ST, SPRINGFIELD, IL 62704-3943
(217) 492-2000
Mailing address
1945 S SPRING ST, SPRINGFIELD, IL 62704-3943
(217) 492-2000
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036-108929
IL
2084P0800X
Psychiatry Physician
036108929
IL
2084P0804X
Child & Adolescent Psychiatry Physician
036-108929
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036108929
—
IL
Enumeration date
10/12/2005
Last updated
01/03/2014
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