Provider Demographics
NPI:1225075104
Name:DANIEL KATZ, M.D., L.L.C.
Entity Type:Organization
Organization Name:DANIEL KATZ, M.D., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-718-0200
Mailing Address - Street 1:1730 PARK ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2688
Mailing Address - Country:US
Mailing Address - Phone:630-718-0200
Mailing Address - Fax:630-718-0900
Practice Address - Street 1:4696 N MARINE DR
Practice Address - Street 2:SUITE 5B
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-5714
Practice Address - Country:US
Practice Address - Phone:773-564-6090
Practice Address - Fax:773-564-6091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1634876OtherBLUE CROSS / BLUE SHIELD
IL209798Medicare ID - Type Unspecified