Provider Demographics
NPI:1629116256
Name:LANING, DALE ARTHUR (DPM)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:ARTHUR
Last Name:LANING
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15750 S BELL RD STE 2E
Mailing Address - Street 2:
Mailing Address - City:HOMER GLEN
Mailing Address - State:IL
Mailing Address - Zip Code:60491-2686
Mailing Address - Country:US
Mailing Address - Phone:708-301-4443
Mailing Address - Fax:708-301-4413
Practice Address - Street 1:15750 S BELL RD STE 2E
Practice Address - Street 2:
Practice Address - City:HOMER GLEN
Practice Address - State:IL
Practice Address - Zip Code:60491-2686
Practice Address - Country:US
Practice Address - Phone:708-301-4443
Practice Address - Fax:708-301-4413
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-03
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0060001184OtherBLUE CROSS BLUE SHIELD
IL1144490001Medicare NSC
ILT37532Medicare UPIN
IL0060001184OtherBLUE CROSS BLUE SHIELD