Individual
DANIEL HARRY HAVLICHEK III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(507) 284-2511
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(888) 584-7888
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
30034
MN
207R00000X
Internal Medicine Physician
67751
MN
207RG0100X
Gastroenterology Physician
Primary
036.160678
IL
Other
Enumeration date
03/26/2019
Last updated
01/22/2024
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