Healthcare Provider Details

I. General information

NPI: 1831127232
Provider Name (Legal Business Name): ROBERT J DALEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 10/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 ESSINGTON RD
JOLIET IL
60435-8427
US

IV. Provider business mailing address

951 ESSINGTON RD
JOLIET IL
60435-8431
US

V. Phone/Fax

Practice location:
  • Phone: 815-744-4551
  • Fax: 815-744-4756
Mailing address:
  • Phone: 815-744-4551
  • Fax: 815-744-4517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number036066910
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number01058736A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: