Individual
DR. MICHAEL J DAVALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2650 WARRENVILLE RD, STE 280, DOWNERS GROVE, IL 60515
(630) 324-7916
(630) 324-7946
Mailing address
2650 WARRENVILLE RD, STE 280, DOWNERS GROVE, IL 60515
(630) 324-7916
(630) 324-7946
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
01055379A
IN
2086S0129X
Vascular Surgery Physician
036066312
IL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
01055379A
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
036066312
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
344390
DU PAGE GROUP
—
05
—
36066316
—
IL
01
—
526620
COOK GROUP
—
Enumeration date
04/21/2006
Last updated
02/14/2020
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