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Individual

DR. DONALD W DIXON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3231 EUCLID AVE, SUITE 201, BERWYN, IL 60402-3471
(708) 783-2055
(708) 783-2181
Mailing address
19001 OLD LAGRANGE RD, MOKENA, IL 60448-8012
(708) 478-3600
(708) 478-3552

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036047316
IL
207RC0000X
Cardiovascular Disease Physician
Primary
036047316
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01621208
BLUECROSS BLUE SHIELD
IL
05
036047316
IL
01
060062412
RAILROAD MEDICARE COOK
IL
01
1508810086
GROUP NPI
IL
01
236550
MEDICARE GROUP
IL
Enumeration date
04/14/2006
Last updated
04/21/2008
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