Provider Demographics
NPI:1043454739
Name:WARDER, DONNA R (APN-CNM)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:R
Last Name:WARDER
Suffix:
Gender:F
Credentials:APN-CNM
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:ROSE
Other - Last Name:MATRAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:225 N MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-4304
Mailing Address - Country:US
Mailing Address - Phone:847-941-7600
Mailing Address - Fax:847-941-7698
Practice Address - Street 1:225 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-4304
Practice Address - Country:US
Practice Address - Phone:847-941-7600
Practice Address - Fax:847-941-7698
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.336685163W00000X
IL209.007637363LF0000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily