Individual
DANIEL GREGORY LATYSHEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 S PAULINA ST STE 403, CHICAGO, IL 60612-3806
(312) 942-5495
Mailing address
600 S PAULINA ST STE 403, CHICAGO, IL 60612-3806
(312) 942-5495
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
125.085517
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
IL
Other
Enumeration date
09/12/2021
Last updated
07/18/2025
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