MEDICARE: DR. ARTHUR DOUBAH JOSEPH DNP

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	363LG0600X	Gerontology Nurse Practitioner	209.033912	IL

General Provider Information

NPI Number	:	1093671133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARTHUR DOUBAH JOSEPH DNP

Provider Business Mailing Address
First Line	:	2003 W FULTON ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-2345
Country	:	US
Telephone Number	:	312-243-2223
Fax Number	:	312-243-2227

Provider Business Practice Location Address
First Line	:	2003 W FULTON ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-2345
Country	:	US
Telephone Number	:	312-243-2223
Fax Number	:	312-243-2227

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

Provider Enumeration Date	:	01/02/2026
Last Update Date	:	02/10/2026

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