Individual
MRS. DAWN INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RSA
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
238.000090
IL
246ZS0410X
Surgical Technologist
238000090
IL
363AS0400X
Surgical Physician Assistant
Primary
238.000090
IL
Other
Enumeration date
10/14/2008
Last updated
10/04/2018
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