Provider Demographics
NPI:1891465803
Name:LYONS, DAWN M (COTA)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:M
Last Name:LYONS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 ROYAL SAINT GEORGE DR APT 201
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2326
Mailing Address - Country:US
Mailing Address - Phone:630-788-7613
Mailing Address - Fax:
Practice Address - Street 1:825 CARILLON DR
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-4581
Practice Address - Country:US
Practice Address - Phone:630-788-7613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant