Provider Demographics
NPI:1265451199
Name:DUNN, DAVID B (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:DUNN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:BRUCE
Other - Last Name:DUNN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1901 BUTTERFIELD RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-7915
Mailing Address - Country:US
Mailing Address - Phone:630-725-2768
Mailing Address - Fax:630-725-2783
Practice Address - Street 1:12400 OLIVE BLVD
Practice Address - Street 2:#203
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-5454
Practice Address - Country:US
Practice Address - Phone:317-878-2100
Practice Address - Fax:314-878-2107
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036065804207Q00000X
FLME102728202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No202K00000XAllopathic & Osteopathic PhysiciansPhlebology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0533210001OtherDMERC
FL91307OtherBCBS
MODF3698Medicare PIN
MO152670007Medicare PIN
MOP0101175Medicare PIN
FL91307OtherBCBS
IL0533210001OtherDMERC
ILC43424Medicare UPIN