Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 036141484 | IL |
NPI | 1184823411 |
---|---|
Provider Name | Dana M Delach |
First Address | Barrington, IL 60010-3141 |
Second Address | Barrington, IL 60010-3141 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2007 |
Last Update Date | 17/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036141484 | LICENSE (01) | IL |