Provider Demographics
NPI:1871600429
Name:GELYANA, DENNIS (MD, MPH)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:GELYANA
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 WAUKEGAN RD
Mailing Address - Street 2:SUITE 213
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-2165
Mailing Address - Country:US
Mailing Address - Phone:847-998-5556
Mailing Address - Fax:847-998-9156
Practice Address - Street 1:1500 WAUKEGAN RD
Practice Address - Street 2:SUITE 213
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-2165
Practice Address - Country:US
Practice Address - Phone:847-998-5556
Practice Address - Fax:847-998-9156
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA852832084P0800X
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01635203OtherBLUE CROSS BLUE SHIELD
IL212064Medicare ID - Type Unspecified
ILK00835Medicare UPIN