Provider Demographics
NPI:1730465139
Name:D&A MEDICAL LTD
Entity Type:Organization
Organization Name:D&A MEDICAL LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TORAL
Authorized Official - Middle Name:D
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-861-3911
Mailing Address - Street 1:680 N LAKE SHORE DR STE 930
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-8700
Mailing Address - Country:US
Mailing Address - Phone:312-861-3911
Mailing Address - Fax:
Practice Address - Street 1:680 N LAKE SHORE DR STE 930
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-8700
Practice Address - Country:US
Practice Address - Phone:312-861-3911
Practice Address - Fax:312-861-3912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-29
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-109927261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center