Individual
DAVID JOSEPH POWERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
215 E 1ST ST STE 315, DIXON, IL 61021-3190
(815) 288-1035
(815) 284-0584
Mailing address
102 S HENNEPIN AVENUE, KSB MEDICAL GROUP/TOWN SQUARE CENTER, DIXON, IL 61021-0000
(815) 288-1035
(815) 284-0584
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036082587
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036082587
—
IL
01
—
381220029
MEDICARE
IL
Enumeration date
10/12/2005
Last updated
08/23/2018
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