Provider Demographics
NPI:1821677550
Name:DUNSTON, LORIN
Entity Type:Individual
Prefix:
First Name:LORIN
Middle Name:
Last Name:DUNSTON
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 1:732 E 90TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60619-7502
Mailing Address - Country:US
Mailing Address - Phone:773-941-9681
Mailing Address - Fax:
Practice Address - Street 1:2601 W MARQUETTE RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-1817
Practice Address - Country:US
Practice Address - Phone:773-941-9681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker