Provider Demographics
NPI:1366624694
Name:BUCHHOLZ, DONALD HENRY (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:HENRY
Last Name:BUCHHOLZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25910 W TIMBERLAKE RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-1435
Mailing Address - Country:US
Mailing Address - Phone:847-846-7536
Mailing Address - Fax:847-526-7042
Practice Address - Street 1:25910 W TIMBERLAKE RD
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-1435
Practice Address - Country:US
Practice Address - Phone:847-846-7536
Practice Address - Fax:847-526-7042
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-28
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36-057084207ZB0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine