Healthcare Provider Details

I. General information

NPI: 1356811715
Provider Name (Legal Business Name): ALISON S DIXON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2018
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 RIDGE AVE STE 1223
EVANSTON IL
60201-1700
US

IV. Provider business mailing address

2650 RIDGE AVE STE 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 847-982-3171
  • Fax:
Mailing address:
  • Phone: 847-570-1204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149016622
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: