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Individual

DR. DANIEL J PESAVENTO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
27790 W HWGH 22, STE#37, BARRINGTON, IL 60010-2396
(847) 382-4406
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
036065375
IL
207V00000X
Obstetrics & Gynecology Physician
Primary
036065375
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036065375
IL
Enumeration date
04/20/2006
Last updated
01/27/2023
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