Individual
DANIEL A PACELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
16522 106TH CT, ORLAND PARK, IL 60467-4547
(708) 361-2266
(708) 361-3200
Mailing address
16522 106TH CT, ORLAND PARK, IL 60467-4547
(708) 361-2266
(708) 361-3200
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036066758
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031602369
BLUE CROSS
IL
01
—
020006885
RAILROAD MEDICARE
IL
05
—
036066758
—
IL
01
—
F400409513
MEDICARE PTAN
IL
Enumeration date
06/27/2005
Last updated
08/20/2019
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