Individual
MR. DANIEL LEO DOHERTY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
259 E ERIE ST FL 17, CHICAGO, IL 60611-2987
(312) 926-6000
(312) 926-0516
Mailing address
259 E ERIE ST FL 17, CHICAGO, IL 60611-2987
(312) 926-6000
(312) 926-0516
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085008221
IL
Other
Enumeration date
01/06/2017
Last updated
10/25/2021
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