Provider Demographics
NPI:1023455623
Name:SZARKE, DAWN MICHELE (CPNP-BC)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MICHELE
Last Name:SZARKE
Suffix:
Gender:F
Credentials:CPNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13872 W EMMA LN
Mailing Address - Street 2:
Mailing Address - City:METTAWA
Mailing Address - State:IL
Mailing Address - Zip Code:60045-3411
Mailing Address - Country:US
Mailing Address - Phone:719-338-5175
Mailing Address - Fax:
Practice Address - Street 1:4102 PINION DR
Practice Address - Street 2:10TH MEDICAL GROUP
Practice Address - City:USAF ACADEMY
Practice Address - State:CO
Practice Address - Zip Code:80840-2502
Practice Address - Country:US
Practice Address - Phone:719-333-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.009991363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics