Healthcare Provider Details

I. General information

NPI: 1831153907
Provider Name (Legal Business Name): MARY ELIZABETH DALY RNC MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 N LAKE SHORE DR SUITE 1317
CHICAGO IL
60611-4546
US

IV. Provider business mailing address

680 N LAKE SHORE DR SUITE 1317
CHICAGO IL
60611-4546
US

V. Phone/Fax

Practice location:
  • Phone: 312-440-3810
  • Fax: 312-440-1572
Mailing address:
  • Phone: 312-440-3810
  • Fax: 312-440-1572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: