Provider Demographics
NPI:1831688829
Name:DUDEK, KATHERINE EMMA (DPT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:EMMA
Last Name:DUDEK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:866-370-8206
Mailing Address - Fax:517-435-3670
Practice Address - Street 1:2400 BOSTON ST STE 114
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-4780
Practice Address - Country:US
Practice Address - Phone:410-826-6585
Practice Address - Fax:410-826-6586
Is Sole Proprietor?:No
Enumeration Date:2018-05-04
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator