Provider Demographics
NPI:1194808451
Name:DUNN, BRIAN HOWARD (DPM)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:HOWARD
Last Name:DUNN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 W BARTLETT AVE
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-4235
Mailing Address - Country:US
Mailing Address - Phone:630-483-2212
Mailing Address - Fax:630-483-2237
Practice Address - Street 1:108 W BARTLETT AVE
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-4235
Practice Address - Country:US
Practice Address - Phone:630-483-2212
Practice Address - Fax:630-483-2237
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016005035213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK50954Medicare PIN
ILK50957Medicare PIN
ILK51188Medicare PIN
ILK51187Medicare PIN