Provider Demographics
NPI:1831324029
Name:GEORGE F. DALIANIS, DPM, PC
Entity Type:Organization
Organization Name:GEORGE F. DALIANIS, DPM, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:F
Authorized Official - Last Name:DALIANIS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:773-282-6111
Mailing Address - Street 1:5943 W IRVING PARK RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-2618
Mailing Address - Country:US
Mailing Address - Phone:773-282-6111
Mailing Address - Fax:773-725-6600
Practice Address - Street 1:5943 W IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-2618
Practice Address - Country:US
Practice Address - Phone:773-282-6111
Practice Address - Fax:773-725-6600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-18
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016.002278213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0661200002Medicare NSC