Provider Demographics
NPI:1659492866
Name:COURTNEY, DANIEL MARK (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:MARK
Last Name:COURTNEY
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 1:259 E ERIE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2930
Mailing Address - Country:US
Mailing Address - Phone:312-694-7000
Mailing Address - Fax:312-926-6274
Practice Address - Street 1:259 E ERIE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2930
Practice Address - Country:US
Practice Address - Phone:312-694-7000
Practice Address - Fax:312-926-6274
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine