DR. VIDA BERNADETTE DYSON (NPI# 1881717288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881717288 |
| Entity Type | Individual |
| Full Name | DR. VIDA BERNADETTE DYSON |
| Credential | PH.D. |
| Practice Address |
9730 S Western Ave Suite 627 Evergreen Park IL 60805-2814 |
| Mailing Address |
9747 S Oakley Ave Chicago IL 60643-1720 |
| Practice Telephone | 7082618922 |
| Practice Fax Number | 7738819535 |
| Mailing Telephone | 7734291847 |
| Mailing Fax Number | 7738819535 |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD | 0001635116 | 01 |
| Street Address |
9730 S WESTERN AVE SUITE 627 |
| City | EVERGREEN PARK |
| State | IL |
| Zip Code | 60805-2814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174515035 | Anita Iyer | Obstetrics & Gynecology | 9730 S Western Ave, Ste 100, Evergreen Park, IL 60805-2814 | 2005-08-17 |
| 1043790017 | Tammie Denise Walker | Social Worker | 9730 S Western Ave, Evergreen Park, IL 60805-2814 | 2018-08-18 |
| 1306385398 | Samantha Louise Allen | Social Worker | 9730 S Western Ave, Evergreen Park, IL 60805 | 2017-02-23 |
| 1700266566 | Central Regional Laboratories, LLC | Clinical Medical Laboratory | 9730 S Western Ave, Suite 706, Evergreen Park, IL 60805-2814 | 2015-06-05 |
| 1669805933 | Fresenius Medical Care Chicagoland, LLC | Clinic/Center | 9730 S Western Ave, Evergreen Park, IL 60805-2814 | 2013-08-09 |
| 1457529943 | Fresenius Medical Care Comprehensive Ckd Services Inc | Clinic/Center | 9730 S Western Ave, Ckd Services of Evergreen Park, Evergreen Park, IL 60805-2814 | 2008-02-19 |
| 1629254156 | Ari Financial Services | Home Health | 9730 S Western Ave, 712, Evergreen Park, IL 60805-2814 | 2008-01-15 |
| 1396938783 | Optimum Home Health Care Inc | Home Health | 9730 S Western Ave, Suite 710, Evergreen Park, IL 60805-2672 | 2007-08-20 |
| 1821122029 | Valentin Berman Md PC | Psychologist | 9730 S Western Ave, Suit 729, Evergreen Park, IL 60805 | 2007-03-16 |
| 1164577920 | Donna J. Calvin | Nurse Practitioner | 9730 S Western Ave, Neomedica Evergreen Park - Ckd Services, Evergreen Park, IL 60805-2814 | 2007-01-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487254603 | Cynthia Nicole Bucio | Pharmacist | 9400 S. Western, Evergreen Park, N/A 60805 | 2020-10-27 |
| 1124530456 | Foundations Counseling, LLC | Social Worker | 9730 S Western Ave Ste 215, Evergreen Park, IL 60805 | 2017-10-26 |
| 1184147886 | Luke Blaeser | Specialist/Technologist | 2856 W. 97th Pl., Evergreen Park, IL 60805 | 2017-07-25 |
| 1396193322 | Daniel Joseph Bierbaum Howard | Emergency Medicine | 2800 95th St, Emergency Department, Evergreen Park, IL 60805 | 2016-05-31 |
| 1588037873 | Lcr Primary Care LLC | Exclusive Provider Organization | 9237 S.pulaski, Ste. 2s, Evergreen Park, IL 60805 | 2015-11-09 |
| 1447639091 | Nancy Sanchez | Social Worker | 9832 S Utica Ave, Evergreen Park, IL 60805 | 2015-05-28 |
| 1629334743 | Harshad M. Mehta Md Sc | Psychiatry & Neurology | 2850 W. 95th Street, Suite 206, Evergreen Park, IL 60805 | 2012-04-03 |
| 1235407305 | Victoria T Adesina | Pharmacist | 8700 South Kedzie Ave, Evergreen Park, IL 60805 | 2011-12-05 |
| 1891072922 | Zahia-lena Refat Hussien | Pharmacist | 8700 S. Kedzie Ave, Evergreen Park, IL 60805 | 2011-11-03 |
| 1891079091 | Denise Adams | Occupational Therapy Assistant | 9217 S. Kedzie, Evergreen Park, IL 60805 | 2011-10-06 |
| Find all providers in zip 60805 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770601064 | Mario M. Gallo & Linda R. Harper Ptr | Psychologist | 3830 W 95th St, Suite 110, Evergreen Park, IL 60805-2004 | 2007-03-26 |
| 1922188929 | Kathy Dana Abbott | Psychologist | 3317 W 95th St, Ste 205, Evergreen Park, IL 60805 | 2006-10-16 |
| 1891729992 | Mario M. Gallo | Psychologist | 3830 W 95th St, Suite 110, Evergreen Park, IL 60805-2004 | 2006-07-11 |
| 1205866068 | Linda Ruth Harper | Psychologist | 3830 W 95th St, Suite 110, Evergreen Park, IL 60805-2004 | 2006-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699166 | Jennifer Knuepfer, Psyd, Pllc | Psychologist | 4256 N Ravenswood Ave Ste 305, Chicago, IL 60613-1114 | 2020-11-03 |
| 1104426170 | Grace Giedgowd | Psychologist | 1640 W Division St Apt 205, Chicago, IL 60622-3939 | 2020-10-29 |
| 1417556283 | Kjp Alliance LLC | Psychologist | 16595 W Easton Ave Ste 1, Lincolnshire, IL 60069-2744 | 2020-10-22 |
| 1184223364 | Caroline Elisabeth Fulton | Psychologist | 1739 N Elston Ave, Chicago, IL 60642-1544 | 2020-10-20 |
| 1881293108 | Haley Michelle Sims | Psychologist | 65 E Wacker Pl Ste 300, Chicago, IL 60601-7203 | 2020-10-19 |
| 1083212005 | Amanda Michele Long | Psychologist | 20280 Governors Hwy Ste 105, Olympia Fields, IL 60461-1068 | 2020-10-12 |
| 1285231936 | Qianhui Zhang | Psychologist | 1225 W Morse Ave Apt 403, Chicago, IL 60626-5751 | 2020-10-06 |
| 1316544158 | Nancy Marie Picard | Psychologist | 4885 N Hermitage Ave, Chicago, IL 60640-4104 | 2020-10-05 |
| 1558978379 | Youngok Kim | Psychologist | 1260 Iroquois Ave Ste 204, Naperville, IL 60563-8548 | 2020-09-25 |
| 1861007049 | Heloisa Garman | Psychologist | 800 Elgin Rd Apt 1611, Evanston, IL 60201-5632 | 2020-09-14 |
| Find all providers with the same taxonomy | ||||
| City | EVERGREEN PARK |
| Zip Code | 60805 |
Please comment or provide details below to improve the information on DR. VIDA BERNADETTE DYSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.