Provider Demographics
NPI:1013462373
Name:MCDONALD, JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 PARTLOW DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-5765
Mailing Address - Country:US
Mailing Address - Phone:630-926-0490
Mailing Address - Fax:
Practice Address - Street 1:700 MURDOCK ST
Practice Address - Street 2:SUITE B
Practice Address - City:SEDRO WOOLLEY
Practice Address - State:WA
Practice Address - Zip Code:98284-1426
Practice Address - Country:US
Practice Address - Phone:360-855-1021
Practice Address - Fax:360-855-0356
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002971A111N00000X
WACH60675217111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor