Provider Demographics
NPI:1881924942
Name:WARREN, DAWN-MARIA ALICIA (MD)
Entity type:Individual
Prefix:DR
First Name:DAWN-MARIA
Middle Name:ALICIA
Last Name:WARREN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 S CALUMET AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-3935
Mailing Address - Country:US
Mailing Address - Phone:312-326-0195
Mailing Address - Fax:312-326-0195
Practice Address - Street 1:3401 S CALUMET AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-3935
Practice Address - Country:US
Practice Address - Phone:312-326-0195
Practice Address - Fax:312-326-0195
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL336.019878 036.05519174400000X
IL336.019878036.055199207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No174400000XOther Service ProvidersSpecialist