Provider Demographics
NPI:1750331260
Name:BALL, DONALD G (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:G
Last Name:BALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-7430
Mailing Address - Country:US
Mailing Address - Phone:630-321-2705
Mailing Address - Fax:
Practice Address - Street 1:801 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-7430
Practice Address - Country:US
Practice Address - Phone:630-321-2705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-0570742085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C42932Medicare UPIN
P08383Medicare PIN