Provider Demographics
NPI:1205819877
Name:DAYAL, AMIT (MD)
Entity Type:Individual
Prefix:
First Name:AMIT
Middle Name:
Last Name:DAYAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5000 S 5TH AVE HINES VA
Mailing Address - Street 2:DEPARTMENT OF MEDICINE 14TH FLOOR MAIL CODE 111
Mailing Address - City:HINES
Mailing Address - State:IL
Mailing Address - Zip Code:60141-5000
Mailing Address - Country:US
Mailing Address - Phone:708-202-5300
Mailing Address - Fax:708-202-2195
Practice Address - Street 1:5000 S 5TH AVE HINES VA
Practice Address - Street 2:DEPARTMENT OF MEDICINE 14TH FLOOR MAIL CODE 111
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141-5000
Practice Address - Country:US
Practice Address - Phone:708-202-5300
Practice Address - Fax:708-202-2195
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2008-04-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILI23422Medicare UPIN