Individual
DR. DESI LAMONT DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2300 N EDWARD ST, DECATUR, IL 62526-4192
(217) 876-8121
Mailing address
2300 N EDWARD ST, DECATUR, IL 62526-4192
(217) 876-8121
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036130511
IL
2085R0204X
Vascular & Interventional Radiology Physician
036130511
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036130511
MD
IL
Enumeration date
11/30/2007
Last updated
12/19/2025
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