Provider Demographics
NPI:1730447657
Name:DILLON, ANTHONY SCOTT (MA, LCPC, CHT)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:SCOTT
Last Name:DILLON
Suffix:
Gender:M
Credentials:MA, LCPC, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7956 BIRCH DR
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46324-3329
Mailing Address - Country:US
Mailing Address - Phone:219-781-1113
Mailing Address - Fax:219-844-0195
Practice Address - Street 1:1314 KENSINGTON RD UNIT 4531
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60522-7136
Practice Address - Country:US
Practice Address - Phone:630-324-4996
Practice Address - Fax:219-844-0195
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-28
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
IL180008405101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1780223529Medicaid