MEDICARE: DANIEL A PACELLA DO PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	0361602369	IL

General Provider Information

NPI Number	:	1376721415
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL A PACELLA DO PC

Provider Business Mailing Address
First Line	:	4N048 NORTON LAKE DR
Second Line	:
City	:	ST CHARLES
State	:	IL
Zip	:	60175-8564
Country	:	US
Telephone Number	:	708-227-7751
Fax Number	:

Provider Business Practice Location Address
First Line	:	16522 106TH CT
Second Line	:
City	:	ORLAND PARK
State	:	IL
Zip	:	60467-4547
Country	:	US
Telephone Number	:	708-361-2266
Fax Number	:	708-361-3200

Authorized Official
Title or Position	:	GENERAL SURGEON
Name	:	DANIEL A PACELLA
Credential	:	DO
Telephone Number	:	708-227-7751

Provider Enumeration Date	:	01/31/2008
Last Update Date	:	04/18/2024

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