Provider Demographics
NPI:1871860601
Name:ADAMO, DANIELE (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIELE
Middle Name:
Last Name:ADAMO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2261 RANDALL RD
Mailing Address - Street 2:
Mailing Address - City:CARPENTERSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60110-3355
Mailing Address - Country:US
Mailing Address - Phone:224-484-8221
Mailing Address - Fax:224-484-8368
Practice Address - Street 1:2261 RANDALL RD
Practice Address - Street 2:
Practice Address - City:CARPENTERSVILLE
Practice Address - State:IL
Practice Address - Zip Code:60110-3355
Practice Address - Country:US
Practice Address - Phone:224-484-8221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-22
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019028644122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist