MEDICARE: DR. JAMAL EDDINE DAKI 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
1	208M00000X	Hospitalist Physician	036110029	IL
2	207R00000X	Internal Medicine Physician	036110029	IL

General Provider Information

NPI Number	:	1841245297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMAL EDDINE DAKI M.D.

Provider Business Mailing Address
First Line	:	700 E OGDEN AVE
Second Line	:	SUITE 202
City	:	WESTMONT
State	:	IL
Zip	:	60559-5569
Country	:	US
Telephone Number	:	630-528-3215
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 E OGDEN AVE
Second Line	:	SUITE 202
City	:	WESTMONT
State	:	IL
Zip	:	60559-5569
Country	:	US
Telephone Number	:	630-528-3215
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	05/24/2021

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