Christopher Lee Donner

Individual provider Active NPI Athletic Trainer · Washington, IL

NPI 1871980359 · NPPES record last updated Dec 8, 2016

Key facts

NPI
1871980359
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
1045 Mallard Way
Washington, IL 61571-8000
Phone
(309) 678-2300
NPI assigned
Apr 22, 2015
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Yes

Addresses

Primary practice location

1045 Mallard Way
Washington, IL 61571-8000

Mailing address

335 Campus LN
Apt 109
Columbia, KY 42728-1486

Other providers in Washington, IL

All providers in Washington, IL · Athletic Trainer in Illinois

Sources for this page

Verify at the official NPI Registry.