Provider Demographics
NPI:1932133188
Name:SOPRON, DAWN ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:ELIZABETH
Last Name:SOPRON
Suffix:
Gender:F
Credentials:LCSW
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 907
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:IL
Mailing Address - Zip Code:60013-0907
Mailing Address - Country:US
Mailing Address - Phone:307-752-7016
Mailing Address - Fax:
Practice Address - Street 1:2615 THREE OAKS RD STE 2A
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:IL
Practice Address - Zip Code:60013-6119
Practice Address - Country:US
Practice Address - Phone:307-752-7016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2020-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLCSW5311041C0700X
IL1490046811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL396827550OtherBCBSIL
WY20890OtherMEDICARE NORIDIAN
WY314353OtherBLUE CROSS BLUE SHIELD
ILF400698462OtherMEDICARE NGS