Provider Demographics
NPI:1689260713
Name:HUNTER, DASHAWN
Entity Type:Individual
Prefix:
First Name:DASHAWN
Middle Name:
Last Name:HUNTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-1341
Mailing Address - Country:US
Mailing Address - Phone:312-217-1971
Mailing Address - Fax:
Practice Address - Street 1:534 1ST ST STE A
Practice Address - Street 2:
Practice Address - City:CRETE
Practice Address - State:IL
Practice Address - Zip Code:60417-2153
Practice Address - Country:US
Practice Address - Phone:708-880-7747
Practice Address - Fax:708-880-7787
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-13
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490223911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical