Provider Demographics
NPI:1245538925
Name:DAWSON, TUESDAY (MSW)
Entity type:Individual
Prefix:
First Name:TUESDAY
Middle Name:
Last Name:DAWSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6719 S CRANDON AVE
Mailing Address - Street 2:#2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-1214
Mailing Address - Country:US
Mailing Address - Phone:312-401-3295
Mailing Address - Fax:
Practice Address - Street 1:203 N OTTAWA ST
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60432-4006
Practice Address - Country:US
Practice Address - Phone:815-723-3405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-04
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0020711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical