Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 036-127079 | IL |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 125-051257 | IL |
NPI | 1003037169 |
---|---|
Provider Name | Lori Cudone |
First Address | Dixon, IL 61021-3198 |
Second Address | Dixon, IL 61021-3198 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 09/04/2021 |