Dawson, Clyde
Dawson, Clyde is an individual health care provider with primary practice located at 2100 Glenwood Ave , Joliet IL 60435-5487. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Dawson, Clyde can be contacted via phone (815) 725-2121.Contact Information
Primary practice address
2100 Glenwood Ave
Joliet IL 60435-5487
Phone: (815) 725-2121
Fax: (815) 741-6303
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 36-063983 | Illinois |
Profile Details
| NPI number | 1174557086 |
|---|---|
| LBN Legal business name | Dawson, Clyde |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 10th, 2006 |
| Last updated | Oct 1st, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174557086 | NPPES |
| Illinois | MEDICAID | 36063983 |
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