Provider Demographics
NPI:1801810197
Name:DUGAR, KIEYA C (MD)
Entity type:Individual
Prefix:DR
First Name:KIEYA
Middle Name:C
Last Name:DUGAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KIEYA
Other - Middle Name:C
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4440 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2600
Practice Address - Country:US
Practice Address - Phone:708-684-2560
Practice Address - Fax:708-684-4932
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-115512207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
279500OtherMEDICARE GROUP
IL036115512 1Medicaid
P00374099OtherRAILROAD MEDICARE
279500OtherMEDICARE GROUP
IL036115512 1Medicaid
IL0407950001Medicare NSC