Dudak, Philip S
Dudak, Philip S is an individual health care provider with primary practice located at 11133 Dunn Rd , Saint Louis MO 63136-6163. He recently has 3 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Dudak, Philip S can be contacted via phone (314) 653-5228.Contact Information
Primary practice address
11133 Dunn Rd
Saint Louis MO 63136-6163
Phone: (314) 653-5228
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Chiropractic Providers / Chiropractor | 111N00000X | 005778 | Missouri |
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 2013003629 | Missouri |
Chiropractic Providers / Chiropractor | 111N00000X | 038006559 | Illinois |
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 209010226 | Illinois |
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 2013003629 | Missouri |
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 209010226 | Illinois |
Profile Details
NPI number | 1720067051 |
---|---|
LBN Legal business name | Dudak, Philip S |
Credentials | DC, FNP-C |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 13th, 2006 |
Last updated | Jul 29th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1720067051 | NPPES |
Illinois | Other | 118828 | BCBS |
Illinois | Other | 4400267 | BCBS |
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