Individual
MS. DOROTY O.D.S. DEVALON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2100 GLENWOOD AVE, JOLIET, IL 60435-5487
(815) 725-2121
(815) 741-5518
Mailing address
PO BOX 713260, CHICAGO, IL 60677
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-008125
IL
Other
Enumeration date
10/22/2018
Last updated
06/26/2023
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