Individual
MICHAEL DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2604 DEMPSTER ST STE 501, PARK RIDGE, IL 60068-8429
(847) 674-5585
Mailing address
2604 DEMPSTER ST STE 501, PARK RIDGE, IL 60068-8429
(847) 674-5585
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
036.175584
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2020
Last updated
08/06/2025
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