Individual
DONALD S CHILDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
610 S MAPLE AVE, SUITE 2500, OAK PARK, IL 60304-1091
(708) 660-2900
(708) 660-2901
Mailing address
610 S MAPLE AVE, SUITE 2500, OAK PARK, IL 60304-1091
(708) 660-2900
(708) 660-2901
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036081440
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01615849
BLUE CROSS BLUE SHIELD
IL
05
—
036081440
—
IL
Enumeration date
01/19/2006
Last updated
08/18/2011
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