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General NPI Number Information
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NPI Number | 1780770446
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Entity Type | Individual
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Provider Name | SUZANNE DALY M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 2160 S 1ST AVE
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City | MAYWOOD
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State | IL
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Zip | 60153-3328
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Country | US
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Telephone | 708-216-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 101 COLE AVE
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City | BISBEE
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State | AZ
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Zip | 85603-1327
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Country | US
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Telephone | 520-432-6481
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Fax | 520-432-5082
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 5105006
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 42912
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 01090370A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 036170692
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License Number State | IL
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