DANIEL JAMES DESTICHE

CHICAGO, IL
NPI1700381316
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2085N0700X Radiology, Neuroradiology
(Licence: WI  83307-20)
Additional Taxonomies2085R0202X Radiology, Diagnostic Radiology
(Licence: IL  036.164915)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2018-03-26
Last Update Date2024-03-21
Business Address
DANIEL JAMES DESTICHE MD
251 E HURON ST
CHICAGO, IL 60611-2908
Phone number: 312-926-2000
Mailing Address
DANIEL JAMES DESTICHE MD
5000 W CHAMBERS ST
MILWAUKEE, WI 53210-1650
Phone number: