Provider Demographics
NPI:1841373156
Name:MCDAID, DAWN MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:MARIE
Last Name:MCDAID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 784
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62401-0784
Mailing Address - Country:US
Mailing Address - Phone:217-342-3371
Mailing Address - Fax:217-347-3328
Practice Address - Street 1:912 N HENRIETTA ST
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-1788
Practice Address - Country:US
Practice Address - Phone:217-342-3337
Practice Address - Fax:217-347-3328
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004014093207V00000X
IL036118793207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208329300Medicaid
IL036118793Medicaid
ILF400222096Medicare PIN
MO208329300Medicaid