Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 125065106 | IL |
NPI | 1063827590 |
---|---|
Provider Name | Danny Jandali |
First Address | Elmhurst, IL 60126-4533 |
Second Address | Elgin, IL 60123-7903 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2014 |
Last Update Date | 31/12/2021 |