MEDICARE: CHRISTOPHER SEAN DUGAN DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	016-004082	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	480005889	OTHER	IL	MEDICARE RAILROAD PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	100822	OTHER	IL	HEALTHLINK
2	4226265	OTHER	IL	AETNA

General Provider Information

NPI Number	:	1639146921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER SEAN DUGAN DPM

Provider Business Mailing Address
First Line	:	2900 FRANK SCOTT PKWY W
Second Line	:	SUITE 900
City	:	BELLEVILLE
State	:	IL
Zip	:	62223-5000
Country	:	US
Telephone Number	:	618-277-5700
Fax Number	:	618-257-7049

Provider Business Practice Location Address
First Line	:	2900 FRANK SCOTT PKWY W
Second Line	:	SUITE 900
City	:	BELLEVILLE
State	:	IL
Zip	:	62223-5000
Country	:	US
Telephone Number	:	618-277-5700
Fax Number	:	618-257-7049

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2006
Last Update Date	:	04/24/2012

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Directions to “ CHRISTOPHER SEAN DUGAN DPM” Practice Location

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