Provider Demographics
NPI:1568628337
Name:DIXON, JULIAN W (MD)
Entity Type:Individual
Prefix:
First Name:JULIAN
Middle Name:W
Last Name:DIXON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3414
Mailing Address - Street 2:SUITE 1107
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-0414
Mailing Address - Country:US
Mailing Address - Phone:773-296-7159
Mailing Address - Fax:
Practice Address - Street 1:180 N MICHIGAN AVE STE 1610
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7401
Practice Address - Country:US
Practice Address - Phone:312-994-3000
Practice Address - Fax:312-201-1202
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125049043207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology