Donna J. Calvin, ARNP

Individual provider Active NPI Nurse Practitioner · Harvey, IL

NPI 1164577920 · NPPES record last updated Jun 15, 2022

Key facts

NPI
1164577920
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
209002917 (IL)
Practice address
31 W 155TH St
Harvey, IL 60426-3556
Phone
(708) 596-5177
Fax
(708) 596-5518
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209002917 IL Yes

Addresses

Primary practice location

31 W 155TH St
Harvey, IL 60426-3556

Mailing address

31 W 155TH St
Harvey, IL 60426-3556
Phone (708) 596-5177

Other practice location 1

9730 S Western Ave
NeoMedica Evergreen Park - CKD Services
Evergreen Park, IL 60805-2814
Phone (708) 423-8833

Other identifiers

IdentifierTypeStateIssuer
209002917MedicaidIL
277001599MedicaidIL

Other providers in Harvey, IL

All providers in Harvey, IL · Nurse Practitioner in Illinois

Sources for this page

Verify at the official NPI Registry.