Liesen, Daniel A

Liesen, Daniel A is an individual health care provider with primary practice located at 927 Broadway St , Quincy IL 62301-2719. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Trauma Surgery. Allopathic & Osteopathic Physicians / Trauma Surgery is his primary health care specialty. Liesen, Daniel A can be contacted via phone (217) 214-3447.

Contact Information

Primary practice address
927 Broadway St Quincy IL 62301-2719
Phone: (217) 214-3447
Fax: (217) 214-5819
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 036115999 Illinois
Allopathic & Osteopathic Physicians / Trauma Surgery 2086S0127X 036115999 Illinois

Profile Details

NPI number 1386747731
LBN Legal business name Liesen, Daniel A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2006
Last updated Feb 2nd, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386747731 NPPES
Illinois MEDICAID 036115999
Illinois Other 036115999

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