Healthcare Provider Details

I. General information

NPI: 1013180421
Provider Name (Legal Business Name): D & S PODIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2008
Last Update Date: 08/10/2020
Certification Date: 08/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 W BARTLETT AVE
BARTLETT IL
60103-4235
US

IV. Provider business mailing address

108 W BARTLETT AVE
BARTLETT IL
60103-4235
US

V. Phone/Fax

Practice location:
  • Phone: 630-483-2212
  • Fax: 630-483-2237
Mailing address:
  • Phone: 630-483-2212
  • Fax: 630-483-2237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ER0200X
TaxonomyRadiology Podiatrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: BRIAN H DUNN
Title or Position: OWNER/PHYSICIAN
Credential: DPM
Phone: 630-483-2212