Provider Demographics
NPI:1376695577
Name:DUMAIS, BRIAN PATRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:PATRICK
Last Name:DUMAIS
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:15030 S RAVINIA AVE
Mailing Address - Street 2:SUITE 38
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-3256
Mailing Address - Country:US
Mailing Address - Phone:708-364-1600
Mailing Address - Fax:708-364-1695
Practice Address - Street 1:15030 S RAVINIA AVE
Practice Address - Street 2:SUITE 38
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-3256
Practice Address - Country:US
Practice Address - Phone:708-364-1600
Practice Address - Fax:708-364-1695
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001635627OtherBLUE CROSS BLUE SHIELD
IL20694OtherADVOCATE HELATH PARTNERS