Individual
DOLORES DIXON-GREVIOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2850 W 95TH ST, SUITE 301, EVERGREEN PARK, IL 60805-2735
(708) 389-2200
(708) 389-6686
Mailing address
2850 W 95TH ST, SUITE 301, EVERGREEN PARK, IL 60805-2735
(708) 389-2200
(708) 389-6686
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-100552
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036100552
—
IL
Enumeration date
01/27/2006
Last updated
04/04/2012
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