Individual
DR. DANIEL JOSEPH JANNOTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4306D W CRYSTAL LAKE RD, MCHENRY, IL 60050
(815) 385-7930
(815) 385-9234
Mailing address
9795 CROSSPOINT BLVD, STE 100, INDIANAPOLIS, IN 46256-3348
(317) 254-6480
(317) 259-8609
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007100
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046007100
—
IL
01
—
05632150
BCBS
IL
01
—
363408484
CORP TAX ID
IL
Enumeration date
09/15/2006
Last updated
03/16/2015
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