MEDICARE: DAWN FAITH MCKENZIE-BROWN

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1639011356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN FAITH MCKENZIE-BROWN

Provider Business Mailing Address
First Line	:	3202 BIRCHWOOD DR
Second Line	:
City	:	HAZEL CREST
State	:	IL
Zip	:	60429-1033
Country	:	US
Telephone Number	:	773-771-9439
Fax Number	:

Provider Business Practice Location Address
First Line	:	3202 BIRCHWOOD DR
Second Line	:
City	:	HAZEL CREST
State	:	IL
Zip	:	60429-1033
Country	:	US
Telephone Number	:	708-762-2907
Fax Number	:

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

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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