Provider Demographics
NPI:1265629281
Name:HOWD MEDICAL LLC
Entity Type:Organization
Organization Name:HOWD MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOWD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-357-8511
Mailing Address - Street 1:271 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:IL
Mailing Address - Zip Code:61360
Mailing Address - Country:US
Mailing Address - Phone:815-357-8511
Mailing Address - Fax:815-357-1238
Practice Address - Street 1:150 W HIGH ST
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450
Practice Address - Country:US
Practice Address - Phone:815-357-8511
Practice Address - Fax:815-357-1238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF59172Medicare UPIN
IL211142Medicare PIN