Provider Demographics
NPI:1225314990
Name:DAHILIG, MARY K (APN, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:K
Last Name:DAHILIG
Suffix:
Gender:F
Credentials:APN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26W212 GENEVA RD
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2240
Mailing Address - Country:US
Mailing Address - Phone:630-510-1065
Mailing Address - Fax:
Practice Address - Street 1:26W212 GENEVA RD
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2240
Practice Address - Country:US
Practice Address - Phone:630-510-1065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209009165363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily