Provider Demographics
NPI:1821420209
Name:TEMPLE, DONALD ERNEST (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:ERNEST
Last Name:TEMPLE
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 1:110 E DELAWARE PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-1481
Mailing Address - Country:US
Mailing Address - Phone:312-664-1708
Mailing Address - Fax:
Practice Address - Street 1:110 E DELAWARE PL
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-1481
Practice Address - Country:US
Practice Address - Phone:312-664-1708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036036036207K00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology