Provider Demographics
NPI:1316039548
Name:NEWMAN, DARYL (DN)
Entity Type:Individual
Prefix:DR
First Name:DARYL
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 DUNDEE RD
Mailing Address - Street 2:SUITE S5
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2318
Mailing Address - Country:US
Mailing Address - Phone:847-272-3700
Mailing Address - Fax:
Practice Address - Street 1:3330 DUNDEE RD
Practice Address - Street 2:SUITE S5
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2318
Practice Address - Country:US
Practice Address - Phone:847-272-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL181-000302172P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172P00000XOther Service ProvidersNaprapath
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0004932565OtherBC/BS