Provider Demographics
NPI:1669541371
Name:DORAN, BARBARA (APRN, CNM)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:DORAN
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:
Other - Last Name:ALIF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:3700 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60623-3824
Mailing Address - Country:US
Mailing Address - Phone:773-542-5203
Mailing Address - Fax:773-542-5841
Practice Address - Street 1:2653 W OGDEN AVE STE 3B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1647
Practice Address - Country:US
Practice Address - Phone:773-522-6100
Practice Address - Fax:773-522-9832
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277.000610367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
P53495Medicare UPIN
367830Medicare PIN