Provider Demographics
NPI:1811365745
Name:DONAHOE, STEPHANIE M (PA-C)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:DONAHOE
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:27650 FERRY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-3846
Mailing Address - Country:US
Mailing Address - Phone:630-225-2663
Mailing Address - Fax:630-225-2399
Practice Address - Street 1:27650 FERRY RD STE 100
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3846
Practice Address - Country:US
Practice Address - Phone:630-225-2663
Practice Address - Fax:630-225-2399
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-09
Last Update Date:2020-05-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL085005621363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant