Healthcare Provider Details

I. General information

NPI: 1710191705
Provider Name (Legal Business Name): LUCY DEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 10/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 MADISON ST SUITE 303
JOLIET IL
60435-6565
US

IV. Provider business mailing address

202 N HAMMES AVE UNIT C
JOLIET IL
60435-8136
US

V. Phone/Fax

Practice location:
  • Phone: 815-714-2240
  • Fax:
Mailing address:
  • Phone: 815-714-2240
  • Fax: 815-582-3597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number036112067
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: