Provider Demographics
NPI:1386254464
Name:DOWD, CHELSEA LOUIS
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:LOUIS
Last Name:DOWD
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 1:1 LIBERTY PLZ STE 301
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10006-1404
Mailing Address - Country:US
Mailing Address - Phone:917-261-4414
Mailing Address - Fax:
Practice Address - Street 1:131 S DEARBORN ST STE 1025
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-5517
Practice Address - Country:US
Practice Address - Phone:917-261-4414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-04
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.021802363LP2300X
NY309739363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care