Provider Demographics
NPI:1134488620
Name:DUDE, CAROLYNN MARIE (MD)
Entity Type:Individual
Prefix:
First Name:CAROLYNN
Middle Name:MARIE
Last Name:DUDE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 KENDALL AVE
Mailing Address - Street 2:APT 3
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53726-3847
Mailing Address - Country:US
Mailing Address - Phone:312-543-1460
Mailing Address - Fax:
Practice Address - Street 1:2650 RIDGE AVE # 1420
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1700
Practice Address - Country:US
Practice Address - Phone:847-570-2860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-03
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036167017207VM0101X
GA82934207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine