Provider Demographics
NPI:1699531434
Name:SANCHEZ AZOCAR, DANIEL JOSE (SA-C)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOSE
Last Name:SANCHEZ AZOCAR
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6394 TRAMORE LN
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-6020
Mailing Address - Country:US
Mailing Address - Phone:779-771-1894
Mailing Address - Fax:
Practice Address - Street 1:6394 TRAMORE LN
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-6020
Practice Address - Country:US
Practice Address - Phone:779-771-1894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL24-160246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant