Individual
DR. DOROTHY T PRUSEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
755 N YORK ST, ELMHURST, IL 60126-1607
(331) 221-2900
(331) 221-2733
Mailing address
755 N YORK ST, ELMHURST, IL 60126-1607
(331) 221-2900
(331) 221-2733
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036081546
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02232472
BLUE CROSS/BLUE SHIELD #
IL
05
—
036081546
—
IL
Enumeration date
07/18/2005
Last updated
02/08/2021
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