Healthcare Provider Details

I. General information

NPI: 1245363332
Provider Name (Legal Business Name): DANIEL GABRIEL ANESZKO D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 N MICHIGAN AVE SUITE 951 W
CHICAGO IL
60611-2252
US

IV. Provider business mailing address

845 N MICHIGAN AVE SUITE 951 W
CHICAGO IL
60611-2252
US

V. Phone/Fax

Practice location:
  • Phone: 312-787-2131
  • Fax:
Mailing address:
  • Phone: 312-787-2131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number019025279
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019-025279
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: