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General NPI Number Information
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NPI Number | 1407274459
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Entity Type | Individual
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Provider Name | WHITNEY MARIE DUNN
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Gender | Female
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Dates
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Enumeration Date | 04/06/2014
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Last Update Date | 04/06/2014
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Provider Practice Location Address
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Address Line | 2160 S 1ST AVE LOYOLA OUTPATIENT CENTER, 2ND FLOOR
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City | MAYWOOD
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State | IL
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Zip | 60153-3328
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Country | US
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Telephone | 708-216-4033
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Fax | 708-216-8546
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Provider Business Mailing Address
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Address Line | 2160 S 1ST AVE
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City | MAYWOOD
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State | IL
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Zip | 60153-3328
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Country | US
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Telephone | 708-216-4033
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Fax | 708-216-8546
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | D500873585780
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License Number State | MI
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