Provider Demographics
NPI:1376651802
Name:DAY, JOHN HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:HOWARD
Last Name:DAY
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 1:180 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:IL
Mailing Address - Zip Code:61520-2670
Mailing Address - Country:US
Mailing Address - Phone:309-647-0201
Mailing Address - Fax:309-649-5101
Practice Address - Street 1:180 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:IL
Practice Address - Zip Code:61520-2670
Practice Address - Country:US
Practice Address - Phone:309-647-0201
Practice Address - Fax:309-649-6880
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036060365207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1942315197OtherNPI CLINIC NUMBER
IL02922981OtherBCBS
ILCG5172OtherRR MEDICARE GROUP#
IL060365OtherOSF HEALTHPLANS
IL036060365Medicaid
IL115424OtherHEALTH LINK
IL117182OtherHEALTH ALLIANCE
ILIL0176OtherJOHN DEERE
IL115424OtherHEALTH LINK
IL060365OtherOSF HEALTHPLANS
ILD14329Medicare UPIN
ILK27470Medicare PIN