# DANAHER FAMILY MEDICINE SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770914988
- **Authorized official:** MICHELE ANN DANAHER MD (PHYSICIAN)
- **Authorized official phone:** (708) 995-7488

## Contact information

- **Practice address:** 19401 WOLF RD, MOKENA, IL 60448-1100
- **Practice address phone:** (708) 323-7593
- **Mailing address:** PO BOX 94670, OKLAHOMA CITY, OK 73143-4670
- **Mailing address phone:** (708) 323-7593

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 036-102025 | IL | Yes |

## Other

- **Enumeration date:** 12/13/2013
- **Last updated:** 04/13/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1679561773 | INDIVIDUAL NPI | — |