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NPI Code Detail

MEDICARE: DANA C. PERRY M.D.

MEDICARE:   DANA C. PERRY  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician036071807IL

General Provider Information

NPI Number : 1265434658
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANA C. PERRY M.D.
Provider Business Mailing Address
First Line : 101 S MAJOR ST
Second Line :
City : EUREKA
State : IL
Zip : 61530-1246
Country : US
Telephone Number : 309-304-2100
Fax Number :
Provider Business Practice Location Address
First Line : 1225 W LAKE ST
Second Line :
City : MELROSE PARK
State : IL
Zip : 60160-4039
Country : US
Telephone Number : 708-681-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2005
Last Update Date : 06/14/2016

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Directions to “ DANA C. PERRY M.D.” Practice Location

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