Individual
DR. DAWN MICHELLE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
319 E MADISON ST FL 2, SPRINGFIELD, IL 62701-1035
(217) 545-8000
(217) 545-9537
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-8000
(217) 545-2101
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
036.088500
IL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
036.088500
IL
2084P0804X
Child & Adolescent Psychiatry Physician
113680
MO
2084P0804X
Child & Adolescent Psychiatry Physician
J3708
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208917021
—
MO
Enumeration date
10/23/2006
Last updated
09/15/2023
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