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General NPI Number Information
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NPI Number | 1174475263
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Entity Type | Individual
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Provider Name | DENNIS DIXON
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Gender | Male
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Dates
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Enumeration Date | 02/11/2026
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 1426 DOUGLAS AVE
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City | FLOSSMOOR
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State | IL
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Zip | 60422-1713
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Country | US
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Telephone | 708-351-2703
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Fax |
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Provider Business Mailing Address
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Address Line | 1426 DOUGLAS AVE
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City | FLOSSMOOR
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State | IL
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Zip | 60422-1713
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Country | US
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Telephone | 708-351-2703
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 225A00000X
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Taxonomy Name | Music Therapist
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License Number |
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State | IL
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