Individual
MRS. DONNAMARIE PACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1653 W CONGRESS PKWY, CHICAGO, IL 60612-3833
(312) 942-5495
Mailing address
712 S WESTERN AVE, UNIT B, CHICAGO, IL 60612-3574
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
125061351
IL
Other
Enumeration date
06/27/2012
Last updated
01/25/2022
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