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General NPI Number Information
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NPI Number | 1215960026
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Entity Type | Individual
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Provider Name | LEE ANTHONY DUDLEY DO
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Gender | Male
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 11/17/2020
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Provider Practice Location Address
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Address Line | 5113 S HARPER AVE STE 2C
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City | CHICAGO
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State | IL
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Zip | 60615
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Country | US
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Telephone | 773-983-1635
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Fax |
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Provider Business Mailing Address
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Address Line | 5113 S HARPER AVE STE 2C
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City | CHICAGO
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State | IL
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Zip | 60615-4119
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Country | US
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Telephone | 773-983-1635
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 336.091115
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | Q5791
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 34008088
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 2012-02286
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | DO.1490
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License Number State | AL
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Taxonomy #6
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | DO034849
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License Number State | DC
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Taxonomy #7
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 2010025333
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License Number State | MO
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Taxonomy #8
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 057958
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License Number State | GA
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Taxonomy #9
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | H0064685
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License Number State | MD
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Taxonomy #10
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | DOS-1111
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License Number State | HI
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Taxonomy #11
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | DO0000001892
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License Number State | TN
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Taxonomy #12
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 036.129640
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License Number State | IL
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