Individual
THOMAS J DANAHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1340 CHARLES ST, STE 100, ROCKFORD, IL 61104
(779) 696-1900
Mailing address
PO BOX 1567, ROCKFORD, IL 61110-0067
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036056019
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036056019
—
IL
Enumeration date
03/01/2006
Last updated
07/01/2015
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