Healthcare Provider Details

I. General information

NPI: 1700740123
Provider Name (Legal Business Name): DONNA HARRAR LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 LAKE ST
EVANSTON IL
60201-4317
US

IV. Provider business mailing address

920 W WILSON AVE # 616
CHICAGO IL
60640-6447
US

V. Phone/Fax

Practice location:
  • Phone: 847-864-1130
  • Fax:
Mailing address:
  • Phone: 847-864-1130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number227.022269
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: