Provider Demographics
NPI:1609816453
Name:BELL, DONNA M (DO)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:BELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:M
Other - Last Name:STAEHLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:12529 CHIZAR DR
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-1676
Mailing Address - Country:US
Mailing Address - Phone:815-462-8986
Mailing Address - Fax:
Practice Address - Street 1:405 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-1462
Practice Address - Country:US
Practice Address - Phone:618-549-0721
Practice Address - Fax:618-457-0469
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI73207P00000X
IN02002260A207P00000X
IL036.105700207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H81630Medicare UPIN