Provider Demographics
NPI:1518139187
Name:DONOHUE, SIOBHAN T (AUD)
Entity Type:Individual
Prefix:DR
First Name:SIOBHAN
Middle Name:T
Last Name:DONOHUE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5243 N LAMON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-1605
Mailing Address - Country:US
Mailing Address - Phone:773-454-0797
Mailing Address - Fax:
Practice Address - Street 1:5243 N LAMON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-1605
Practice Address - Country:US
Practice Address - Phone:773-454-0797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist