Provider Demographics
NPI:1316070931
Name:DANNY, ADELE LUCI (DO)
Entity type:Individual
Prefix:DR
First Name:ADELE
Middle Name:LUCI
Last Name:DANNY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7675
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-7002
Mailing Address - Country:US
Mailing Address - Phone:847-404-8729
Mailing Address - Fax:847-549-8415
Practice Address - Street 1:142 INDIAN SPRINGS DR
Practice Address - Street 2:MEDICINE SHOPPE PHARMACY CORNER CARE CLINIC
Practice Address - City:SANDWICH
Practice Address - State:IL
Practice Address - Zip Code:60548-1902
Practice Address - Country:US
Practice Address - Phone:815-786-8696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH27558Medicare UPIN