Provider Demographics
NPI:1780357798
Name:BEARNOD, DALANNE JOY GABO (PA-C)
Entity type:Individual
Prefix:
First Name:DALANNE JOY
Middle Name:GABO
Last Name:BEARNOD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 OGDEN AVE STE P050
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-5893
Mailing Address - Country:US
Mailing Address - Phone:630-499-2404
Mailing Address - Fax:304-994-7506
Practice Address - Street 1:444 N EOLA RD STE 110
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502-9619
Practice Address - Country:US
Practice Address - Phone:630-692-5660
Practice Address - Fax:630-692-5661
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085.008484207RG0300X
363A00000X
IL085008484363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine