Provider Demographics
NPI:1124032784
Name:PALOYAN, DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:PALOYAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 CHESTNUT ST
Mailing Address - Street 2:#L03
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3247
Mailing Address - Country:US
Mailing Address - Phone:630-655-0722
Mailing Address - Fax:630-655-0728
Practice Address - Street 1:333 CHESTNUT ST
Practice Address - Street 2:#L03
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3247
Practice Address - Country:US
Practice Address - Phone:630-655-0722
Practice Address - Fax:630-655-0728
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036040049207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL1742008Medicare UPIN
ILIL1742Medicare PIN
544190Medicare ID - Type Unspecified
D11047Medicare UPIN