Individual
C RONALD DONAHOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
1704 BYRNEBRUK DR, CHAMPAIGN, IL 61822-9263
(217) 355-3812
Mailing address
1704 BYRNEBRUK DR, CHAMPAIGN, IL 61822-9263
(217) 355-3812
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036-079214
IL
2085R0202X
Diagnostic Radiology Physician
E4300
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036079214
—
IL
Enumeration date
04/29/2006
Last updated
08/18/2011
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