Dyson, Vida Bernadette

Dyson, Vida Bernadette is an sole proprietor health care provider with primary practice located at 9730 S Western Ave Suite 627, Evergreen Park IL 60805-2814. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Dyson, Vida Bernadette can be contacted via phone (708) 261-8922.

Contact Information

Primary practice address
9730 S Western Ave Suite 627 Evergreen Park IL 60805-2814
Phone: (708) 261-8922
Fax: (773) 881-9535
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X Illinois

Profile Details

NPI number 1881717288
LBN Legal business name Dyson, Vida Bernadette
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 9th, 2007
Last updated Jul 8th, 2007 - about 18 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 1881717288 NPPES
Illinois Other 0001635116 BLUE CROSS BLUE SHIELD

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