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General NPI Number Information
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NPI Number | 1760243968
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Entity Type | Individual
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Provider Name | MEGAN ELIZABETH DONNELLY PHD
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Gender | Female
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Dates
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Enumeration Date | 01/16/2024
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 340 S SCHOOL ST
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City | LOMBARD
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State | IL
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Zip | 60148-3070
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Country | US
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Telephone | 630-516-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 2185 S FINLEY RD APT 1605
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City | LOMBARD
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State | IL
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Zip | 60148-6479
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 2587074
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License Number State | IL
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