Individual
DR. ANNA BIDA-DUDUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
215 E. 1ST STREET, SUITE 215, KSB MEDICAL GROUP, DIXON, IL 61021
(815) 285-5423
(815) 285-5426
Mailing address
215 E. 1ST STREET, SUITE 215, KSB MEDICAL GROUP, DIXON, IL 61021
(815) 285-5423
(815) 285-5426
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036-136200
IL
207V00000X
Obstetrics & Gynecology Physician
4301060145
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036136200
—
IL
01
—
F400173706
MEDICARE
IL
Enumeration date
02/02/2006
Last updated
08/21/2018
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