Active NPI
Julie Dunderdale, M.D.
- Surgery Physician
- Chicago, IL
National Provider Identifier
1457679763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 036.137580
- Practice address
- 250 E Superior St
Suite 4-420
Chicago, IL 60611-2914 - Phone
- (312) 472-4779
- NPI assigned
- May 11, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 036.137580 | IL | Primary |
Addresses
Primary practice location
250 E Superior St
Suite 4-420
Chicago, IL 60611-2914
Mailing address
680 N Lake Shore Dr
Suite 1000
Chicago, IL 60611-4546
Phone (312) 695-0665
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.137580 | IL | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439078400000",
"number": "1457679763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "680 N LAKE SHORE DR",
"address_2": "SUITE 1000",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606114546",
"telephone_number": "312-695-0665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 E SUPERIOR ST",
"address_2": "SUITE 4-420",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112914",
"telephone_number": "312-472-4779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNDERDALE",
"first_name": "JULIE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-11",
"last_updated": "2015-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "036.137580",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.