Provider Demographics
NPI:1831580554
Name:DAWSON, SEAN (DC, LAC)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:DAWSON
Suffix:
Gender:M
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 BUTTERFIELD RD
Mailing Address - Street 2:STE 301N
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1234
Mailing Address - Country:US
Mailing Address - Phone:630-468-1824
Mailing Address - Fax:630-701-1007
Practice Address - Street 1:364 W ARMY TRAIL RD
Practice Address - Street 2:STE 330B
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-5603
Practice Address - Country:US
Practice Address - Phone:630-351-1071
Practice Address - Fax:630-351-1360
Is Sole Proprietor?:No
Enumeration Date:2015-02-17
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012749111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor