Provider Demographics
NPI:1154323541
Name:OCONNOR, DARYL LEN (MD)
Entity Type:Individual
Prefix:
First Name:DARYL
Middle Name:LEN
Last Name:OCONNOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:360 W BUTTERFIELD RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5068
Mailing Address - Country:US
Mailing Address - Phone:630-782-9600
Mailing Address - Fax:630-782-1643
Practice Address - Street 1:360 W BUTTERFIELD RD
Practice Address - Street 2:SUITE 160
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5068
Practice Address - Country:US
Practice Address - Phone:630-782-9600
Practice Address - Fax:630-782-1643
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-106488207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02222323OtherBCBS
IL036106488Medicaid
ILP00055308OtherMEDICARE RAILROAD
IL036106488Medicaid
IL0139440002Medicare NSC
ILL98401Medicare PIN
IL02222323OtherBCBS
ILP00055308OtherMEDICARE RAILROAD