MEDICARE: DENNIS DIXON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	101YM0800X	Mental Health Counselor	IL
2	101YP1600X	Pastoral Counselor	IL
3	225A00000X	Music Therapist	IL
4	171W00000X	Contractor	IL

General Provider Information

NPI Number	:	1174475263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENNIS DIXON

Provider Business Mailing Address
First Line	:	1426 DOUGLAS AVE
Second Line	:
City	:	FLOSSMOOR
State	:	IL
Zip	:	60422-1713
Country	:	US
Telephone Number	:	708-351-2703
Fax Number	:

Provider Business Practice Location Address
First Line	:	1426 DOUGLAS AVE
Second Line	:
City	:	FLOSSMOOR
State	:	IL
Zip	:	60422-1713
Country	:	US
Telephone Number	:	708-351-2703
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	03/03/2026

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Directions to “ DENNIS DIXON ” Practice Location

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