Individual
MIA DONOGHUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2050 PFINGSTEN RD STE 200, GLENVIEW, IL 60026-1373
(847) 657-1820
Mailing address
2050 PFINGSTEN RD STE 200, GLENVIEW, IL 60026-1373
(847) 657-1820
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209019886
IL
Other
Enumeration date
11/20/2019
Last updated
11/21/2019
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