Healthcare Provider Details

I. General information

NPI: 1013919737
Provider Name (Legal Business Name): DANIEL KATZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 06/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 OGDEN AVE STE 304
AURORA IL
60504
US

IV. Provider business mailing address

2040 OGDEN AVE STE 304
AURORA IL
60504-7205
US

V. Phone/Fax

Practice location:
  • Phone: 630-898-3727
  • Fax:
Mailing address:
  • Phone: 630-898-3727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number036-093373
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: