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NPI Code Detail

MEDICARE: DR. CAMILLE DUNKLEY MD

MEDICARE: DR. CAMILLE DUNKLEY MD
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
1207PT0002XMedical Toxicology (Emergency Medicine) Physician036-150874IL
2390200000XStudent in an Organized Health Care Education/Training Program
3207QA0401XAddiction Medicine (Family Medicine) Physician036150874IL
4207Q00000XFamily Medicine Physician036-150874IL

General Provider Information

NPI Number : 1720493455
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CAMILLE DUNKLEY MD
Provider Business Mailing Address
First Line : 1276 FULTON AVE
Second Line :
City : BRONX
State : NY
Zip : 10456-3402
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 319 E MADISON ST STE 1F
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62701-3118
Country : US
Telephone Number : 217-545-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2014
Last Update Date : 04/16/2026

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