Provider Demographics
NPI:1124404736
Name:DUNAHEE, LORILEE
Entity Type:Individual
Prefix:
First Name:LORILEE
Middle Name:
Last Name:DUNAHEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:FAIRBURY
Mailing Address - State:IL
Mailing Address - Zip Code:61739-1509
Mailing Address - Country:US
Mailing Address - Phone:815-692-2833
Mailing Address - Fax:815-692-3278
Practice Address - Street 1:106 S 1ST ST
Practice Address - Street 2:
Practice Address - City:FAIRBURY
Practice Address - State:IL
Practice Address - Zip Code:61739-1509
Practice Address - Country:US
Practice Address - Phone:815-692-2833
Practice Address - Fax:815-692-3278
Is Sole Proprietor?:No
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041259267363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner