Provider Demographics
NPI:1891788154
Name:DALY, CLAUDE A (DPM)
Entity Type:Individual
Prefix:MR
First Name:CLAUDE
Middle Name:A
Last Name:DALY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2315 E 93RD ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-3988
Mailing Address - Country:US
Mailing Address - Phone:773-493-4300
Mailing Address - Fax:773-493-4499
Practice Address - Street 1:2315 E 93RD ST STE 200
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-3988
Practice Address - Country:US
Practice Address - Phone:773-493-4300
Practice Address - Fax:773-493-4499
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2022-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016 004690213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU37591Medicare UPIN
IL5357520001Medicare NSC