Provider Demographics
NPI:1861679888
Name:DYERS, JAMES VINCENT JR (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:VINCENT
Last Name:DYERS
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 N DIVISION ST
Mailing Address - Street 2:SUITE 604
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-1182
Mailing Address - Country:US
Mailing Address - Phone:815-941-3882
Mailing Address - Fax:815-941-3884
Practice Address - Street 1:1802 N DIVISION ST
Practice Address - Street 2:SUITE 604
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450-1182
Practice Address - Country:US
Practice Address - Phone:815-941-3882
Practice Address - Fax:815-941-3884
Is Sole Proprietor?:No
Enumeration Date:2008-01-22
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1192892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry