Provider Demographics
NPI:1710566526
Name:JUNGELS, DAWN LORAINE
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:LORAINE
Last Name:JUNGELS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DAWN
Other - Middle Name:LORAINE
Other - Last Name:HERIAUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1630 PLUM ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-3462
Mailing Address - Country:US
Mailing Address - Phone:630-966-4475
Mailing Address - Fax:
Practice Address - Street 1:1630 PLUM ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-3462
Practice Address - Country:US
Practice Address - Phone:630-966-4475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health