Provider Demographics
NPI:1225649064
Name:LANKENAU, DANIEL ARTHUR (DPT)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ARTHUR
Last Name:LANKENAU
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 CHICAGO AVE APT A
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2320
Mailing Address - Country:US
Mailing Address - Phone:630-740-8252
Mailing Address - Fax:
Practice Address - Street 1:254 CHICAGO AVE APT A
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2320
Practice Address - Country:US
Practice Address - Phone:630-740-8252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070024522225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist