Individual
CLYDE DAWSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2100 GLENWOOD AVE, JOLIET, IL 60435-5487
(815) 725-2121
(815) 741-6303
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-0018
(815) 725-2121
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
36-063983
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36063983
—
IL
Enumeration date
07/10/2006
Last updated
10/01/2015
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