Individual
MRS. CHE-IA D DONELY-WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
141 W 46TH AVE, GARY, IN 46408-3905
(312) 785-3863
Mailing address
141 W 46TH AVE, GARY, IN 46408-3905
(312) 785-3863
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
28279273A
IN
163WH0500X
Hemodialysis Registered Nurse
041.4622619
IL
163WI0500X
Infusion Therapy Registered Nurse
041.462619
IL
Other
Enumeration date
03/24/2025
Last updated
03/24/2025
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