Individual
MS. DAWN CARROLL ROMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1051 ESSINGTON RD, SUITE 280, JOLIET, IL 60435-2801
(815) 744-8554
(815) 744-3969
Mailing address
820 SPRINGER DR, LOMBARD, IL 60148-6413
(815) 744-8554
(630) 495-1770
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085000381
IL
363AS0400X
Surgical Physician Assistant
10000242A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01618941
BC/BS
IL
Enumeration date
07/22/2005
Last updated
08/01/2019
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