Provider Demographics
NPI:1265512693
Name:DORNE, PAMELA E (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:E
Last Name:DORNE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PAMELA
Other - Middle Name:E
Other - Last Name:AYRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:201 E OGDEN AVE STE 212
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3680
Mailing Address - Country:US
Mailing Address - Phone:708-383-3883
Mailing Address - Fax:888-596-8376
Practice Address - Street 1:201 E OGDEN AVE STE 212
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3680
Practice Address - Country:US
Practice Address - Phone:708-383-3883
Practice Address - Fax:888-596-8376
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036071844207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036071844Medicaid
02215723OtherBCBS OF IL
K47450OtherMEDICARE PTAN
K47449OtherMEDICARE PTAN
02215723OtherBCBS OF IL