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NPI Code Detail

MEDICARE: DR. DONNA M GLOVER-ROGERS PH.D.

MEDICARE: DR. DONNA M GLOVER-ROGERS PH.D.
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
1103TS0200XSchool Psychologist
2103TS0200XSchool Psychologist417240NM

General Provider Information

NPI Number : 1538865563
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONNA M GLOVER-ROGERS PH.D.
Provider Business Mailing Address
First Line : 2049 N SAYRE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60707-3823
Country : US
Telephone Number : 773-882-3625
Fax Number :
Provider Business Practice Location Address
First Line : 2049 N SAYRE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60707-3823
Country : US
Telephone Number : 773-882-3625
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2023
Last Update Date : 02/01/2023

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