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NPI Code Detail

MEDICARE: AMANDA MCDONALD FNP

MEDICARE:   AMANDA  MCDONALD  FNP
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
1363LF0000XFamily Nurse Practitioner209.027746IL

General Provider Information

NPI Number : 1053098582
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA MCDONALD FNP
Provider Business Mailing Address
First Line : 1102 W ARGYLE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60640-3610
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1102 W ARGYLE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60640-3610
Country : US
Telephone Number : 773-394-2888
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2023
Last Update Date : 07/31/2023

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Directions to “ AMANDA MCDONALD FNP” Practice Location

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