Provider Demographics
NPI:1962507772
Name:DANIELE, CHRISTOPHER ANTHONY (DPM)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ANTHONY
Last Name:DANIELE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3347 VOLLMER RD
Mailing Address - Street 2:
Mailing Address - City:FLOSSMOOR
Mailing Address - State:IL
Mailing Address - Zip Code:60422-2003
Mailing Address - Country:US
Mailing Address - Phone:708-799-2900
Mailing Address - Fax:708-799-2919
Practice Address - Street 1:3347 VOLLMER RD
Practice Address - Street 2:
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-2003
Practice Address - Country:US
Practice Address - Phone:708-799-2900
Practice Address - Fax:708-799-2919
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016003688213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5276150001OtherDMERC
ILT02272Medicare UPIN