Provider Demographics
NPI:1801929799
Name:RITACCA, DANIEL JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOHN
Last Name:RITACCA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:230 CENTER DR
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1584
Mailing Address - Country:US
Mailing Address - Phone:847-367-8815
Mailing Address - Fax:866-367-8319
Practice Address - Street 1:230 CENTER DR
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1584
Practice Address - Country:US
Practice Address - Phone:847-367-8815
Practice Address - Fax:847-367-8819
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL2086S0122X207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILB95525Medicare UPIN