Provider Demographics
NPI:1326252685
Name:MCDOUGALL, PATRICIA MAE (NP)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:MAE
Last Name:MCDOUGALL
Suffix:
Gender:
Credentials:NP
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:MAE
Other - Last Name:WOZIWODZKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1159 KNOLLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067
Mailing Address - Country:US
Mailing Address - Phone:847-439-5857
Mailing Address - Fax:
Practice Address - Street 1:1321 CEDAR LN
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-2227
Practice Address - Country:US
Practice Address - Phone:931-222-4207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209006416363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00786040OtherMEDICARE RAILROAD
ILK48330Medicare PIN
ILK48331Medicare PIN