| Phyllis Dawson, Psy.d., LLC | |
|
666 Dundee Rd Ste 1302 Northbrook IL 60062-2736 | |
| (224) 326-0025 | |
| (847) 400-5828 |
| Full Name | Phyllis Dawson, Psy.d., LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 666 Dundee Rd Ste 1302, Northbrook, Illinois |
| Authorized Official Name and Position | Phyllis Dawson (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 2243260025 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phyllis Dawson, Psy.d., LLC 666 Dundee Rd Ste 1302 Northbrook IL 60062-2736 Ph: (224) 326-0025 | Phyllis Dawson, Psy.d., LLC 666 Dundee Rd Ste 1302 Northbrook IL 60062-2736 Ph: (224) 326-0025 |
| NPI Number | 1063061984 |
|---|---|
| Provider Enumeration Date | 09/04/2019 |
| Last Update Date | 09/25/2019 |
| Medicare PECOS PAC ID | 3678804705 |
|---|---|
| Medicare Enrollment ID | O20191003003120 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063061984 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (NU) | Primary |
| Provider Name | Phyllis M Dawson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346258449 PECOS PAC ID: 0840218954 Enrollment ID: I20051108000111 |
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