Provider Demographics
NPI:1669459228
Name:CAMERON, DONNETTE M (D C)
Entity Type:Individual
Prefix:DR
First Name:DONNETTE
Middle Name:M
Last Name:CAMERON
Suffix:
Gender:F
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:WEST DUNDEE
Mailing Address - State:IL
Mailing Address - Zip Code:60118-1234
Mailing Address - Country:US
Mailing Address - Phone:847-426-2420
Mailing Address - Fax:847-426-2450
Practice Address - Street 1:212 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:WEST DUNDEE
Practice Address - State:IL
Practice Address - Zip Code:60118-1234
Practice Address - Country:US
Practice Address - Phone:847-426-2420
Practice Address - Fax:847-426-2450
Is Sole Proprietor?:No
Enumeration Date:2005-12-26
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-007136111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4505649OtherBCBS
IL4505649OtherBCBS