Provider Demographics
NPI:1376031625
Name:PAVER, DONNA MARIE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:MARIE
Last Name:PAVER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 W GALENA BLVD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-4305
Mailing Address - Country:US
Mailing Address - Phone:630-692-5960
Mailing Address - Fax:630-692-5961
Practice Address - Street 1:1901 W GALENA BLVD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-4305
Practice Address - Country:US
Practice Address - Phone:630-692-5960
Practice Address - Fax:630-692-5961
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-23
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.318860363LF0000X, 163W00000X
IL209018254363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse