| Doctor Name: | MR. NICHOLAS DILLON |
| NPI Number: | 1275822397 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.S., M.A., SACIT |
| License Number: | 16282-130 |
| Business Practice Address: | 325 Forest Grove Dr Suite 201 Pewaukee, WI - 530723894 |
| Business Phone Number: | 2626912980 |
| Business Fax Number: | 2626912972 |
| Mailing Address: | 3815 N Brookfield Rd, Suite 104-141 BROOKFIELD |
| State: | WI |
| Postal Code: | 530451964 |
| Phone Number: | 8663059818 |
| Fax Number: | 4149089618 |
| NPI Enumeration Date: | 03/29/2011 |
| NPI Last Update Date: | 03/29/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 16282-130 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |