Dixon-Grevious, Dolores

Dixon-Grevious, Dolores is an individual health care provider with primary practice located at 2850 W 95Th St Suite 301, Evergreen Park IL 60805-2735. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Dixon-Grevious, Dolores can be contacted via phone (708) 389-2200.

Contact Information

Primary practice address
2850 W 95Th St Suite 301 Evergreen Park IL 60805-2735
Phone: (708) 389-2200
Fax: (708) 389-6686
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036-100552 Illinois

Profile Details

NPI number 1023089133
LBN Legal business name Dixon-Grevious, Dolores
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2006
Last updated Apr 4th, 2012 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023089133 NPPES
Illinois MEDICAID 036100552

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