Dawn R Broers, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149010960 Issued in IL

Practice address

183 E Bethel Dr
Bourbonnais, IL 60914-1456

Phone

(815) 939-1900

Fax

(815) 939-1902

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dawn R Randak Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313625600000",
    "number": "1629180369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 E BETHEL DR",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141456",
            "telephone_number": "815-939-1900",
            "fax_number": "815-939-1902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 E BETHEL DR",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141456",
            "telephone_number": "815-939-1900",
            "fax_number": "815-939-1902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROERS",
        "first_name": "DAWN",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149010960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "RANDAK",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Social Worker in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.