=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053933838
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JENNIFER C DUNN, MD & ASSOCIATES OB/GYN, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/14/2020
-----------------------------------------------------
Last Update Date | 08/01/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3080 OGDEN AVE STE 305
-----------------------------------------------------
City | LISLE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60532-1681
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-272-2281
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3080 OGDEN AVE STE 305
-----------------------------------------------------
City | LISLE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60532-1681
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-272-2281
-----------------------------------------------------
Fax | 833-471-6106
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | DR. JENNIFER COLLEEN DUNN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 630-272-2281
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------