Provider Demographics
NPI:1417708710
Name:DONKOR, LINDA A
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:A
Last Name:DONKOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 N CICERO AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-2143
Mailing Address - Country:US
Mailing Address - Phone:847-972-1135
Mailing Address - Fax:833-545-1879
Practice Address - Street 1:3306 W 63RD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-3317
Practice Address - Country:US
Practice Address - Phone:773-424-8109
Practice Address - Fax:833-545-1879
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-27
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209028508363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health