Provider Demographics
NPI:1972225050
Name:DANCE, ISABEL ANN
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:ANN
Last Name:DANCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ISABEL
Other - Middle Name:ANN
Other - Last Name:GALLIGANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3024 N ASHLAND AVE - P.O. BOX 57493
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657
Mailing Address - Country:US
Mailing Address - Phone:330-461-4122
Mailing Address - Fax:
Practice Address - Street 1:1100 LAKE ST STE 280D
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1015
Practice Address - Country:US
Practice Address - Phone:330-461-4122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041455930163WR1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR1000XNursing Service ProvidersRegistered NurseReproductive Endocrinology/Infertility