Individual
DR. DEEPAK P DALIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
840 S WAUKEGAN RD, SUITE 214, LAKE FOREST, IL 60045-2608
(847) 298-2192
Mailing address
520 E 22ND ST, LOMBARD, IL 60148-6110
(630) 874-2542
(630) 874-2642
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036051924
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036051924
—
IL
01
—
202926
GROUP PTAN
IL
Enumeration date
08/02/2005
Last updated
01/19/2015
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