Healthcare Provider Details

I. General information

NPI: 1912923095
Provider Name (Legal Business Name): CATHERINE M DUDLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 HEALTHWAY DR
AURORA IL
60504-4163
US

IV. Provider business mailing address

28594 NETWORK PL
CHICAGO IL
60673-1285
US

V. Phone/Fax

Practice location:
  • Phone: 630-851-3105
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number036-074033
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: