Doctor Name: | DAWN NENDZE |
NPI Number: | 1053586578 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | N532-1737-4878 |
Business Practice Address: | 4100 Veterans Pkwy Mchenry, IL - 600508350 |
Business Phone Number: | 8153856400 |
Business Fax Number: | |
Mailing Address: | 4100 Veterans Pkwy, MCHENRY |
State: | IL |
Postal Code: | 600508350 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/25/2008 |
NPI Last Update Date: | 11/10/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | N532-1737-4878 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |