Basic Information
| Provider Information | |||||||||
| NPI: | 1174056907 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUNLAP | ||||||||
| FirstName: | BURTON | ||||||||
| MiddleName: | DENNARD | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 WESTBROOK CORPORATE CTR | ||||||||
| Address2: | STE 240 | ||||||||
| City: | WESTCHESTER | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601545745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7082362600 | ||||||||
| FaxNumber: | 7084095179 | ||||||||
| Practice Location | |||||||||
| Address1: | 1611 W HARRISON ST STE 201 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606124861 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3129425495 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2017 | ||||||||
| LastUpdateDate: | 06/07/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 036.159742 | IL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.