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Individual

DANIEL JAMES FITZGERALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12935 GREGORY ST, BLUE ISLAND, IL 60406
(708) 597-2000
Mailing address
METROSOUTH MEDICAL CENTER, 12935 S GREGORY ST, BLUE ISLAND, IL 60406
(708) 597-2000

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036146100
IL
390200000X
Student in an Organized Health Care Education/Training Program
VA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/05/2011
Last updated
09/12/2018
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