Active NPI
Clemea J Donaldson, MD
- Professional Counselor
- Chicago, IL
National Provider Identifier
1962023192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 7260 S South Shore Dr
Chicago, IL 60649-2858 - Phone
- (773) 707-1533
- NPI assigned
- Apr 28, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prevention Professional | 405300000X | 20100134711 | TX | |
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
7260 S South Shore Dr
Chicago, IL 60649-2858
Mailing address
7260 S South Shore Dr Apt 3B
Chicago, IL 60649-2703
Phone (773) 707-1533
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20100134711 | TX | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588032000000",
"number": "1962023192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7260 S SOUTH SHORE DR APT 3B",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606492703",
"telephone_number": "773-707-1533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7260 S SOUTH SHORE DR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606492858",
"telephone_number": "773-707-1533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONALDSON",
"first_name": "CLEMEA",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-28",
"last_updated": "2020-04-28",
"certification_date": "2020-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "TX",
"license": "20100134711",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.