Provider Demographics
NPI:1346387487
Name:CONKLIN-DANAO, DEANNA LYN (PSYD)
Entity type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:LYN
Last Name:CONKLIN-DANAO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 N CICERO AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-2112
Mailing Address - Country:US
Mailing Address - Phone:312-493-2628
Mailing Address - Fax:847-983-4783
Practice Address - Street 1:7101 N CICERO AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-2112
Practice Address - Country:US
Practice Address - Phone:312-493-2628
Practice Address - Fax:847-983-4783
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071006438103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1636778OtherBCBS OF IL PPO PROVIDER