MEDICARE: MS. JANET DONEGAN NP

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	363L00000X	Nurse Practitioner	119058	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104897792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANET DONEGAN NP

Provider Business Mailing Address
First Line	:	2800 N LAKE SHORE DR
Second Line	:	1601
City	:	CHICAGO
State	:	IL
Zip	:	60657-6232
Country	:	US
Telephone Number	:	773-472-7075
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 W POLK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3723
Country	:	US
Telephone Number	:	312-864-5204
Fax Number	:	312-864-9782

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

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	07/08/2007

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