Provider Demographics
NPI:1619521986
Name:DEMPSEY, DEBRA LYNNE (NP-C)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LYNNE
Last Name:DEMPSEY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:LYNNE
Other - Last Name:KODA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20 E DUNDEE RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-4384
Mailing Address - Country:US
Mailing Address - Phone:847-459-3800
Mailing Address - Fax:
Practice Address - Street 1:20 E DUNDEE RD
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-4384
Practice Address - Country:US
Practice Address - Phone:847-459-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-25
Last Update Date:2021-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILF07190958363LF0000X
IL209019960363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily