Individual
DR. BILL BATES DAILY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9 PARK PL, SWANSEA, IL 62226-2967
(618) 233-5722
(618) 233-7069
Mailing address
9 PARK PL, SWANSEA, IL 62226-2967
(618) 233-5722
(618) 233-7069
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
036092758
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036054159
SUBSTANCE CONTROL
IL
01
—
036092758
LICENSE
IL
01
—
102595
BNDD
MO
01
—
R4P78
LICENSE
MO
Enumeration date
06/24/2005
Last updated
08/06/2012
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