Provider Demographics
NPI:1760826333
Name:DUMAIS PEDIATRICS, SC
Entity Type:Organization
Organization Name:DUMAIS PEDIATRICS, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:DUMAIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-364-1600
Mailing Address - Street 1:10750 W 143RD ST
Mailing Address - Street 2:SUITE 50
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-1924
Mailing Address - Country:US
Mailing Address - Phone:708-364-1600
Mailing Address - Fax:708-364-1695
Practice Address - Street 1:10750 W 143RD ST
Practice Address - Street 2:SUITE 50
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-1924
Practice Address - Country:US
Practice Address - Phone:708-364-1600
Practice Address - Fax:708-364-1695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036111602208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty