Provider Demographics
NPI:1992098735
Name:DOLEHIDE, CONOR PATRICK (MD)
Entity type:Individual
Prefix:
First Name:CONOR
Middle Name:PATRICK
Last Name:DOLEHIDE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 SILVER CROSS BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-9629
Mailing Address - Country:US
Mailing Address - Phone:815-215-8292
Mailing Address - Fax:815-215-8289
Practice Address - Street 1:1851 SILVER CROSS BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451
Practice Address - Country:US
Practice Address - Phone:773-680-4296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME123479207N00000X
IL125:059285207R00000X
IL036135853207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine