Individual
AMANDA NIKOL DONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12251 S 80TH AVE, PALOS HEIGHTS, IL 60463-1290
(708) 923-4000
Mailing address
12251 S 80TH AVE, PALOS HEIGHTS, IL 60463-1290
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
036.160965
IL
Other
Enumeration date
04/24/2019
Last updated
07/06/2023
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