Provider Demographics
NPI:1982709879
Name:DEANO, DANILO ANGELES (MD)
Entity Type:Individual
Prefix:DR
First Name:DANILO
Middle Name:ANGELES
Last Name:DEANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4643 N CLARK ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-4619
Mailing Address - Country:US
Mailing Address - Phone:773-989-1099
Mailing Address - Fax:773-989-1925
Practice Address - Street 1:2222 W DIVISION ST
Practice Address - Street 2:SUITE # 300
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-2717
Practice Address - Country:US
Practice Address - Phone:773-292-9791
Practice Address - Fax:773-292-9792
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036046873207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01623617OtherBCBS IL DEANO MEDICAL ASS
IL036046873Medicaid
IL1630322OtherBCBS IL WICKER PARK HEART
060065883OtherRRCARE WICKER PARK HEART
791061528OtherRRCARE DEANO MEDICAL ASSO
791061528OtherRRCARE DEANO MEDICAL ASSO
060065883OtherRRCARE WICKER PARK HEART
IL036046873Medicaid