Individual
DONALD WASHINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2179 ASTER CIR, LYNWOOD, IL 60411-8500
(708) 335-7329
Mailing address
2179 ASTER CIR, LYNWOOD, IL 60411-8500
(708) 335-7329
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
900414819-60411-01
—
IL
Enumeration date
01/03/2012
Last updated
01/03/2012
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