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Individual

MS. CAROLEE JAYNE DUNIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
4769 W CERMAK RD, MILE SQUARE HEALTH CENTER AT CICERO, CICERO, IL 60804-2508
(312) 413-7425
Mailing address
1532 OSTRANDER AVE, LA GRANGE PARK, IL 60526-1354
(708) 482-0098

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041-221584
IL
163W00000X
Registered Nurse
585551
CA
367A00000X
Advanced Practice Midwife
209-001585
IL
367A00000X
Advanced Practice Midwife
Primary
NMW 1535
CA

Other

Enumeration date
12/14/2006
Last updated
11/04/2010
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