Individual
JEROME T DALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1890 SILVER CROSS BLVD STE 265, NEW LENOX, IL 60451-9623
(815) 469-8806
Mailing address
1890 SILVER CROSS BLVD, STE 265, NEW LENOX, IL 60451-9623
(815) 727-4292
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036057011
IL
207QG0300X
Geriatric Medicine (Family Medicine) Physician
036-057011
IL
Other
Enumeration date
10/10/2006
Last updated
08/12/2019
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