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NPI Code Detail

MEDICARE: DR. DANIEL LEE GARRISON MD

MEDICARE: DR. DANIEL LEE GARRISON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208M00000XHospitalist Physician036121658IL
2207R00000XInternal Medicine Physician036121658IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00673340OTHERILMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215913652
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL LEE GARRISON MD
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-5114
Country : US
Telephone Number : 847-390-5900
Fax Number : 630-856-9933
Provider Business Practice Location Address
First Line : 4025 N WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-3726
Country : US
Telephone Number : 773-275-7700
Fax Number : 773-279-6504
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2005
Last Update Date : 06/27/2022

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