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General NPI Number Information
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NPI Number | 1396773693
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Entity Type | Individual
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Provider Name | KATHLEEN MARIE DALY DPM
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Gender | Female
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 04/18/2016
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Provider Practice Location Address
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Address Line | 10431 S KEDZIE AVE
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City | CHICAGO
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State | IL
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Zip | 60655-2017
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Country | US
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Telephone | 773-239-8660
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Fax | 773-239-9087
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Provider Business Mailing Address
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Address Line | 2010 N HARLEM AVE
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City | ELMWOOD PARK
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State | IL
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Zip | 60707-3119
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Country | US
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Telephone | 773-239-8660
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Fax | 773-239-9087
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 01600440
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License Number State | IL
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