Dr. Clemea J Donaldson, MD
Counselor, Professional in Chicago, IL. Individual provider (NPI-1).
NPI number1962023192
StatusActive
Last updated in NPPESApr 28, 2020
Details
- NPI
- 1962023192
- Entity type
- Individual (NPI-1)
- Name
- Dr. Clemea J Donaldson
- Credential
- MD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 28, 2020
- Certification date
- Apr 28, 2020
- Last updated
- Apr 28, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | – | – | Yes |
| 405300000X | Prevention Professional | 20100134711 | TX |
Practice location
7260 S South Shore DrChicago, IL 60649-2858
Phone 773-707-1533
Mailing address
7260 S South Shore Dr Apt 3bChicago, IL 60649-2703
Phone 773-707-1533
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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