Healthcare Provider Details

I. General information

NPI: 1104006758
Provider Name (Legal Business Name): RAYMOND DAOU, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2007
Last Update Date: 11/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N RIVER RD STE 200
DES PLAINES IL
60016-1272
US

IV. Provider business mailing address

150 N RIVER RD STE 200
DES PLAINES IL
60016-1272
US

V. Phone/Fax

Practice location:
  • Phone: 847-297-0333
  • Fax: 847-297-8336
Mailing address:
  • Phone: 847-297-0333
  • Fax: 847-297-8336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. RAYMOND DAOU
Title or Position: PRESIDENT
Credential: M.D.
Phone: 847-297-0333