Individual
DONALD ELDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 E ORANGE ST, HOOPESTON, IL 60942-1802
(217) 283-5644
(217) 283-7432
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6792
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036106255
IL
207Q00000X
Family Medicine Physician
Primary
MD8089
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0172078073
—
IL
05
—
050005
—
HI
Enumeration date
10/07/2005
Last updated
12/26/2014
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