Individual
DR. CRYSTAL BANKS DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
228 E LAKE ST, ADDISON, IL 60101-2889
(630) 835-1430
(630) 835-1433
Mailing address
228 E LAKE ST, ADDISON, IL 60101-2889
(630) 835-1430
(630) 835-1433
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301057725
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4483489
—
MI
Enumeration date
07/08/2005
Last updated
02/18/2021
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