Individual
DEANA L DY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
25 S VIRGINIA ST, SUITE 203, CRYSTAL LAKE, IL 60014-5800
(815) 459-5440
Mailing address
25 S VIRGINIA ST, CRYSTAL LAKE, IL 60014-5800
(815) 459-5440
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
036-057986
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCBS4901048
BCBS
IL
Enumeration date
08/23/2005
Last updated
07/08/2007
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