MEDICARE: JAMES SCOTT DONALDSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085P0229X	Pediatric Radiology Physician	036-070919	IL
2	2085R0204X	Vascular & Interventional Radiology Physician	036-070919	IL
3	2085R0202X	Diagnostic Radiology Physician	036-070919	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	021622158	OTHER	IL	CMMG BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225022312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES SCOTT DONALDSON M.D.

Provider Business Mailing Address
First Line	:	225 E CHICAGO AVE #9
Second Line	:	ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO
City	:	CHICAGO
State	:	IL
Zip	:	60611-2991
Country	:	US
Telephone Number	:	312-227-3502
Fax Number	:	312-227-9784

Provider Business Practice Location Address
First Line	:	225 E CHICAGO AVE # 9
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2991
Country	:	US
Telephone Number	:	312-227-3502
Fax Number	:	312-227-9784

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2005
Last Update Date	:	06/04/2020

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Directions to “ JAMES SCOTT DONALDSON M.D.” Practice Location

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