Provider Demographics
NPI:1437890142
Name:DUMMER, DAVID RONALD (DPM)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RONALD
Last Name:DUMMER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17901 GOVERNORS HWY STE 205
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-1146
Mailing Address - Country:US
Mailing Address - Phone:708-206-0777
Mailing Address - Fax:
Practice Address - Street 1:17901 GOVERNORS HWY STE 205
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-1146
Practice Address - Country:US
Practice Address - Phone:708-206-0777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07001494A213E00000X
IL016.006117213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist