Organization
DANAHER FAMILY MEDICINE SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE ANN DANAHER MD (PHYSICIAN)
(708) 995-7488
Entity
Organization
Contact information
Practice address
19401 WOLF RD, MOKENA, IL 60448-1100
(708) 323-7593
Mailing address
PO BOX 94670, OKLAHOMA CITY, OK 73143-4670
(708) 323-7593
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
036-102025
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679561773
INDIVIDUAL NPI
—
Enumeration date
12/13/2013
Last updated
04/13/2016
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