Provider Demographics
NPI:1083662902
Name:CHACHKO, DANIEL J (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:CHACHKO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 423
Mailing Address - Street 2:
Mailing Address - City:NEWTON FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44444-1261
Mailing Address - Country:US
Mailing Address - Phone:330-872-1500
Mailing Address - Fax:330-872-1466
Practice Address - Street 1:119 RIDGE RD
Practice Address - Street 2:SUITE B
Practice Address - City:NEWTON FALLS
Practice Address - State:OH
Practice Address - Zip Code:44444-1261
Practice Address - Country:US
Practice Address - Phone:330-872-1500
Practice Address - Fax:330-872-1466
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1896111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH290747773003OtherMMOH
OH000000141154OtherBCBS
OH000000141154OtherBCBS