Provider Demographics
NPI:1447609870
Name:DUNLAP-WRIGHT, LACHANDA LEANN
Entity Type:Individual
Prefix:
First Name:LACHANDA
Middle Name:LEANN
Last Name:DUNLAP-WRIGHT
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 1:233 E 13TH ST APT 1509
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3252
Mailing Address - Country:US
Mailing Address - Phone:254-630-4834
Mailing Address - Fax:
Practice Address - Street 1:1400 S LAKE PARK AVE STE 205
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-6791
Practice Address - Country:US
Practice Address - Phone:219-942-8620
Practice Address - Fax:219-942-6356
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.069164390200000X
IN02006018A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program