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NPI Code Detail

MEDICARE: DANIEL GUILLERMO DAVILA M.D.

MEDICARE: DANIEL GUILLERMO DAVILA M.D.
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
1208600000XSurgery Physician61656-20WI
2208600000XSurgery Physician080171GA
3208600000XSurgery Physician036150641IL

General Provider Information

NPI Number : 1558637124
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL GUILLERMO DAVILA M.D.
Provider Business Mailing Address
First Line : 800 N WESTMORELAND RD STE 100
Second Line :
City : LAKE FOREST
State : IL
Zip : 60045-1671
Country : US
Telephone Number : 847-234-4310
Fax Number : 847-234-4336
Provider Business Practice Location Address
First Line : 800 N WESTMORELAND RD STE 100
Second Line :
City : LAKE FOREST
State : IL
Zip : 60045-1671
Country : US
Telephone Number : 847-234-4310
Fax Number : 847-234-4336
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2012
Last Update Date : 03/06/2023

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