Provider Demographics
NPI:1043227200
Name:ALAM, DANESH A (MD)
Entity Type:Individual
Prefix:DR
First Name:DANESH
Middle Name:A
Last Name:ALAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DANESH
Other - Middle Name:
Other - Last Name:ALAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:109 SYMONDS DR UNIT 297
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60522-7325
Mailing Address - Country:US
Mailing Address - Phone:630-321-1115
Mailing Address - Fax:630-321-1116
Practice Address - Street 1:27W350 HIGH LAKE RD STE 208
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1262
Practice Address - Country:US
Practice Address - Phone:630-933-6767
Practice Address - Fax:708-686-0010
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-1011132084P0800X
FLME977122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH61702Medicare UPIN