Individual
DANA P PERES EDELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., MS
Contact information
Practice address
5841 S MARYLAND AVE, MC 5000, W312, CHICAGO, IL 60637-1447
(773) 834-2191
(773) 834-2238
Mailing address
180 HARVESTER DR, SUITE 110, MC 1099, BURR RIDGE, IL 60527-7594
(773) 834-4740
(773) 834-0946
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036111499
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036111499
—
IL
Enumeration date
10/01/2007
Last updated
05/27/2009
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