Basic Information
Provider Information
NPI: 1033439641
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUMONT
FirstName: NANCY
MiddleName: R.
NamePrefix: MRS.
NameSuffix:  
Credential: OT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 INGALLS DR
Address2:  
City: HARVEY
State: IL
PostalCode: 604263558
CountryCode: US
TelephoneNumber: 7083332300
FaxNumber:  
Practice Location
Address1: 1 INGALLS DR
Address2:  
City: HARVEY
State: IL
PostalCode: 604263558
CountryCode: US
TelephoneNumber: 7083332300
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/04/2010
LastUpdateDate: 06/04/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
283X00000X ILY HospitalsRehabilitation Hospital 

No ID Information.


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