Individual
DR. DONNA ELISE PRATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
01042194A
IN
174400000X
Specialist
036052546
IL
174400000X
Specialist
Primary
MD-15819
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1606654
BLUE CROSS SHIELD PIN #
IL
01
—
363543494
TAX ID #
IL
01
—
C39290
UPIN #
IL
Enumeration date
12/13/2006
Last updated
01/19/2011
Update your record
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