Provider Demographics
NPI:1598543241
Name:DOWDY, SEAN
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:DOWDY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 S MICHIGAN AVE STE 1450
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60603-6176
Mailing Address - Country:US
Mailing Address - Phone:312-786-4990
Mailing Address - Fax:
Practice Address - Street 1:122 S MICHIGAN AVE STE 1450
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-6176
Practice Address - Country:US
Practice Address - Phone:312-786-4990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178019255101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health