Individual
DR. SUZANNE DALY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
101 COLE AVE, BISBEE, AZ 85603-1327
(520) 432-6481
(520) 432-5082
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
01090370A
IN
207RG0100X
Gastroenterology Physician
Primary
036170692
IL
207RG0100X
Gastroenterology Physician
42912
AZ
207RG0100X
Gastroenterology Physician
5105006
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51050061200001
VALUE CARE
UT
01
—
68277
PUBLIC EMPLOYEES
UT
01
—
QM0000058317
ALTIUS
UT
Enumeration date
10/04/2006
Last updated
12/17/2024
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