Individual
ALTHEA LORRAINE DUMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2539 W 117TH ST, CHICAGO, IL 60655-1539
(815) 209-1001
Mailing address
2539 W 117TH ST, CHICAGO, IL 60655-1539
(815) 209-1001
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041.293686
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041.293686
REGISTERED NURSE
IL
Enumeration date
03/16/2022
Last updated
03/16/2022
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