O Carroll, Daniel Thomas

O Carroll, Daniel Thomas is an sole proprietor health care provider with primary practice located at 22W654 Butterfield Rd , Glen Ellyn IL 60137-6957. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Sports Medicine, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Sports Medicine is his primary health care specialty. O Carroll, Daniel Thomas can be contacted via phone (630) 790-4442.

Contact Information

Primary practice address
22W654 Butterfield Rd Glen Ellyn IL 60137-6957
Phone: (630) 790-4442
Fax: (630) 790-9472
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Sports Medicine 213ES0000X 016-003265 Illinois
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 016-003265 Illinois

Profile Details

NPI number 1437142858
LBN Legal business name O Carroll, Daniel Thomas
Credentials DPM, DABPS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 31st, 2005
Last updated Jun 10th, 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 1437142858 NPPES
Illinois Other 626570 MEDICARE PTAN
Illinois MEDICAID 016003265 MEDICARE PTAN

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