MEDICARE: DR. DANIEL JOSEPH FARRUGIA M.D., PH.D., F.A.C.S

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
1	208600000X	Surgery Physician	036141768	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	036141768	OTHER	IL	STATE LICENSE

General Provider Information

NPI Number	:	1710130901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL JOSEPH FARRUGIA M.D., PH.D., F.A.C.S

Provider Business Mailing Address
First Line	:	875 N MICHIGAN AVE STE 3620
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-1947
Country	:	US
Telephone Number	:	312-999-5505
Fax Number	:	872-666-1985

Provider Business Practice Location Address
First Line	:	875 N MICHIGAN AVE STE 3620
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-1947
Country	:	US
Telephone Number	:	312-999-5505
Fax Number	:	872-666-1985

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2008
Last Update Date	:	06/17/2024

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