Individual
DR. JOYAL DEGANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
520 S MAPLE AVE, OAK PARK, IL 60304-1022
(312) 404-4657
Mailing address
520 S MAPLE AVE, OAK PARK, IL 60304-1022
(312) 404-4657
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
01047470A
IN
207L00000X
Anesthesiology Physician
Primary
036089149
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
399980
GROUP MEDICARE PTAN
IL
01
—
CN4921
RRMC
—
Enumeration date
05/08/2006
Last updated
11/29/2021
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