Healthcare Provider Details

I. General information

NPI: 1972583417
Provider Name (Legal Business Name): DANIEL G BRUETMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OUTPATIENT CARE CENTER DOWNTOWN CHICAGO 160 E. ILLINOIS STREET
CHICAGO IL
60611
US

IV. Provider business mailing address

OUTPATIENT CARE CENTER DOWNTOWN CHICAGO 160 E. ILLINOIS STREET
CHICAGO IL
60611
US

V. Phone/Fax

Practice location:
  • Phone: 312-477-2400
  • Fax:
Mailing address:
  • Phone: 312-477-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number01054353A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number036072153
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: