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NPI Code Detail

MEDICARE: DR. DANIEL S DOOLITTLE M.D.

MEDICARE: DR. DANIEL S DOOLITTLE 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
1207P00000XEmergency Medicine Physician036-091188IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2046800OTHERHEALTH ALLIANCE

General Provider Information

NPI Number : 1912957051
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL S DOOLITTLE M.D.
Provider Business Mailing Address
First Line : 2250 N ILLINOIS AVE
Second Line :
City : CARBONDALE
State : IL
Zip : 62901-5612
Country : US
Telephone Number : 618-833-1691
Fax Number : 855-968-6372
Provider Business Practice Location Address
First Line : 8 DOCTORS PARK RD
Second Line :
City : MOUNT VERNON
State : IL
Zip : 62864-6224
Country : US
Telephone Number : 618-241-8798
Fax Number : 618-244-6010
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 08/22/2023

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