Provider Demographics
NPI:1003835448
Name:WEST, DANIEL K (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:K
Last Name:WEST
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2650 RIDGE AVE
Mailing Address - Street 2:DEPARTMENT OF RADIOLOGY, G507
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1718
Mailing Address - Country:US
Mailing Address - Phone:847-570-2475
Mailing Address - Fax:847-570-2942
Practice Address - Street 1:2650 RIDGE AVE
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY, G507
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1718
Practice Address - Country:US
Practice Address - Phone:847-570-2475
Practice Address - Fax:847-570-2942
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
IL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG75858Medicare UPIN