Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Dearborn National Life Insurance Company before sending sensitive documents. FaxFlow is not affiliated with this organization.
Dearborn National Life Insurance Company fax number
(630) 495-0575
Privacy/PHI Compliance
Used for: Submission and processing of standard PHI authorization forms; PHI communications and claim-related correspondence
Fax destination details
- Department
- Privacy/PHI Compliance
- Purpose
- Submission and processing of standard PHI authorization forms; PHI communications and claim-related correspondence
- Form
- Standard Authorization to Use or Disclose Protected Health Information (PHI) — Standard Authorization to Use or Disclose Protected Health Information (PHI)
- Address
- 701 E 22nd St, Ste 300, Lombard, IL 60148
- Voice phone
- 800-348-4512
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Complete the authorization with identifying details, scope, dates, and sign; fax to the number below to authorize disclosure of PHI to the named recipient.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
FaxFlow records the public sources found during directory research. A source link is useful evidence, but it is not a guarantee that a number still reaches the same team.
No public source link was saved with this record. Confirm the number directly with the organization before using it.