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NPI Code Detail

MEDICARE: DAWN T MITCHELL

MEDICARE: DAWN T MITCHELL
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor180013420IL

General Provider Information

NPI Number : 1598408098
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAWN T MITCHELL
Provider Business Mailing Address
First Line : 1105 S WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60612-4146
Country : US
Telephone Number : 312-746-5905
Fax Number : 312-746-4491
Provider Business Practice Location Address
First Line : 1105 S WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60612-4146
Country : US
Telephone Number : 312-746-5905
Fax Number : 312-746-4491
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2022
Last Update Date : 04/14/2022

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Directions to “ DAWN T MITCHELL ” Practice Location

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