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NPI Code Detail

MEDICARE: DR. THOMAS LEONARD DONAHUE III D.C.

MEDICARE: DR. THOMAS LEONARD DONAHUE III D.C.
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
1111N00000XChiropractor038009384IL

General Provider Information

NPI Number : 1780692988
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS LEONARD DONAHUE III D.C.
Provider Business Mailing Address
First Line : 922 W DIVERSEY PKWY
Second Line :
City : CHICAGO
State : IL
Zip : 60614-1416
Country : US
Telephone Number : 773-529-0057
Fax Number : 773-529-0231
Provider Business Practice Location Address
First Line : 922 W DIVERSEY PKWY
Second Line :
City : CHICAGO
State : IL
Zip : 60614-1416
Country : US
Telephone Number : 773-529-0057
Fax Number : 773-529-0231
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2006
Last Update Date : 02/27/2025

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