Provider Demographics
NPI:1821278565
Name:RAYMOND DAOU, MD, PC
Entity Type:Organization
Organization Name:RAYMOND DAOU, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:DAOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-297-0333
Mailing Address - Street 1:111 SPRING ST
Mailing Address - Street 2:ST FRANCIS HALL STE 302
Mailing Address - City:STREATOR
Mailing Address - State:IL
Mailing Address - Zip Code:61364-3332
Mailing Address - Country:US
Mailing Address - Phone:847-297-0333
Mailing Address - Fax:
Practice Address - Street 1:111 SPRING ST
Practice Address - Street 2:ST FRANCIS HALL STE 302
Practice Address - City:STREATOR
Practice Address - State:IL
Practice Address - Zip Code:61364-3332
Practice Address - Country:US
Practice Address - Phone:847-297-0333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL060009015207Y00000X, 207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic AllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL211608Medicare PIN