Provider Demographics
NPI:1023262789
Name:DAWSON, AMBER LYNN (OD)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:LYNN
Last Name:DAWSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1763 FREEDOM DR
Mailing Address - Street 2:SUITE 129
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-3548
Mailing Address - Country:US
Mailing Address - Phone:630-445-0095
Mailing Address - Fax:630-505-1070
Practice Address - Street 1:1763 FREEDOM DR
Practice Address - Street 2:SUITE 129
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-3548
Practice Address - Country:US
Practice Address - Phone:630-445-0095
Practice Address - Fax:630-505-1070
Is Sole Proprietor?:No
Enumeration Date:2008-11-07
Last Update Date:2016-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-009081152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist