Lee Anthony Dudley, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036.129640 Issued in IL

Practice address

5113 S Harper Ave Ste 2C
Chicago, IL 60615

Phone

(773) 983-1635

NPI assigned

Jul 8, 2006

Last updated

Nov 17, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 12

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Revive Beauty & Drip Lounge, PLLC

  • Infusion Therapy Clinic/Center
  • Burlington, NC
  • NPI 1174226146
  NPD
• Advocate Health and Hospitals Corporation

  dba Advocate Medical Group

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455
  NPD (past)
• Hannibal Regional Healthcare System Inc

  • Multi-Specialty Clinic/Center
  • Hannibal, MO
  • NPI 1003956095
  NPD (past)
• Lumberton Emergency Medical Associates PC

  • Emergency Medicine Physician
  • Lumberton, NC
  • NPI 1326337163
  NPD (past)
• Middletown Emergency Physicians, Inc.

  • Emergency Medicine Physician
  • Franklin, OH
  • NPI 1932108784
  NPD (past)
• Tennessee Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Memphis, TN
  • NPI 1790919041
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1215960026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5113 S HARPER AVE STE 2C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154119",
            "telephone_number": "773-983-1635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5113 S HARPER AVE STE 2C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60615",
            "telephone_number": "773-983-1635"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1030 Highlands Plaza Dr E",
            "address_2": "Apt 108",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101348",
            "country_code": "US",
            "telephone_number": "937-286-1148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "LEE",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "336.091115",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q5791",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34008088",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2012-02286",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "DO.1490",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "DC",
            "license": "DO034849",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "H0064685",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "HI",
            "license": "DOS-1111",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "DO0000001892",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.129640",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "057958",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2010025333",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walter John Dudek Jr., DDS
• Rosaria Marie Dudgeon, OT
• Brian Dudley, RN
• Emily Dudley, AU.D.
• Hannah Dudley, OTR
• Shauntell Dudley, ED.S
• Tara Elizabeth Dudley, ATC
• Megan Marie Dudney, PA-C
• Anastasiya Dudnyk
• Kathryn Liber Dudun, CPNP-PC

• Emergency Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.