Provider Demographics
NPI:1497478333
Name:DAILEY, DANNA KATHLEEN
Entity Type:Individual
Prefix:
First Name:DANNA
Middle Name:KATHLEEN
Last Name:DAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20105 N MOONBEAM LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IL
Mailing Address - Zip Code:62864-8185
Mailing Address - Country:US
Mailing Address - Phone:224-283-9714
Mailing Address - Fax:
Practice Address - Street 1:20105 N MOONBEAM LN
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IL
Practice Address - Zip Code:62864-8185
Practice Address - Country:US
Practice Address - Phone:224-283-9714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker