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Individual

DANIEL BUTTERBACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2500 W REYNOLDS ST, PONTIAC, IL 61764-9774
(708) 783-9100
Mailing address
75 REMITT DR, LOCKBOX 1336, CHICAGO, IL 60675-0001
(866) 916-5259
(231) 922-4030

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01054597A
IN
207P00000X
Emergency Medicine Physician
Primary
036-096060
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036096060
IL
Enumeration date
07/17/2006
Last updated
01/13/2009
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