Basic Information
Provider Information
NPI: 1972891257
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARNETT
FirstName: DANIEL
MiddleName: H
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 611 W PARK ST
Address2: FAPC
City: URBANA
State: IL
PostalCode: 618012529
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 509 W UNIVERSITY AVE
Address2: MILLS CANCER INSTITUTE
City: URBANA
State: IL
PostalCode: 618011645
CountryCode: US
TelephoneNumber: 2173836636
FaxNumber: 2173833466
Other Information
ProviderEnumerationDate: 07/20/2011
LastUpdateDate: 02/04/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0001X036141243ILY Allopathic & Osteopathic PhysiciansRadiologyRadiation Oncology

No ID Information.


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