Dyson, Vida Bernadette
Dyson, Vida Bernadette is an sole proprietor health care provider with primary practice located at 9730 S Western Ave Suite 627, Evergreen Park IL 60805-2814. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Dyson, Vida Bernadette can be contacted via phone (708) 261-8922.Contact Information
Primary practice address
9730 S Western Ave Suite 627
Evergreen Park IL 60805-2814
Phone: (708) 261-8922
Fax: (773) 881-9535
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | Illinois |
Profile Details
| NPI number | 1881717288 |
|---|---|
| LBN Legal business name | Dyson, Vida Bernadette |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 9th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881717288 | NPPES |
| Illinois | Other | 0001635116 | BLUE CROSS BLUE SHIELD |
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