Individual
KATHLEEN ELIZABETH MCDONOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5425 W LAKE ST, CHICAGO, IL 60644-2342
(773) 378-3347
(773) 378-4028
Mailing address
5425 W LAKE ST, CHICAGO, IL 60644-2342
(773) 378-3347
(773) 378-4028
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036123200
IL
207Q00000X
Family Medicine Physician
125051044
IL
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
036123200
IL
Other
Enumeration date
07/19/2007
Last updated
02/17/2021
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