Individual
DANIELLE MARIE SOUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1019 SCHOOL ST, LISLE, IL 60532-1870
(630) 315-8800
(630) 315-8829
Mailing address
1019 SCHOOL ST, LISLE, IL 60532-1870
(630) 315-8800
(630) 315-8829
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
29213
MN
207Q00000X
Family Medicine Physician
Primary
65933
MN
Other
Enumeration date
05/16/2018
Last updated
08/08/2022
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