Doctor Name: | ROANNE F DUNAWAY |
NPI Number: | 1215951884 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.A.-C. |
License Number: | |
Business Practice Address: | 10001 W Roosevelt Rd Suite 304 Westchester, IL - 601542664 |
Business Phone Number: | 7083443550 |
Business Fax Number: | 7083446577 |
Mailing Address: | 10001 W Roosevelt Rd, Suite 304 WESTCHESTER |
State: | IL |
Postal Code: | 601542664 |
Phone Number: | 7083443550 |
Fax Number: | 7083446577 |
NPI Enumeration Date: | 07/27/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |