MEDICARE: DR. JULIA A DYER M.D., M.P.H.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	036-054925	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871575654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIA A DYER M.D., M.P.H.

Provider Business Mailing Address
First Line	:	25 E WASHINGTON ST
Second Line	:	STE 1116
City	:	CHICAGO
State	:	IL
Zip	:	60602-1708
Country	:	US
Telephone Number	:	773-388-1100
Fax Number	:	773-388-2541

Provider Business Practice Location Address
First Line	:	25 E WASHINGTON ST
Second Line	:	STE 1116
City	:	CHICAGO
State	:	IL
Zip	:	60602-1708
Country	:	US
Telephone Number	:	773-388-1100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	02/05/2016

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