Dawson, Clyde

Dawson, Clyde is an individual health care provider with primary practice located at 2100 Glenwood Ave , Joliet IL 60435-5487. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Dawson, Clyde can be contacted via phone (815) 725-2121.

Contact Information

Primary practice address
2100 Glenwood Ave Joliet IL 60435-5487
Phone: (815) 725-2121
Fax: (815) 741-6303
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 36-063983 Illinois

Profile Details

NPI number 1174557086
LBN Legal business name Dawson, Clyde
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated Oct 1st, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174557086 NPPES
Illinois MEDICAID 36063983

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