Provider Demographics
NPI:1407869860
Name:CAMMARANO, DANIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:CAMMARANO
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 1:881 NAPA LN
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-8507
Mailing Address - Country:US
Mailing Address - Phone:630-761-0596
Mailing Address - Fax:630-761-3260
Practice Address - Street 1:14 W DOWNER PL
Practice Address - Street 2:SUITE 12
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-5170
Practice Address - Country:US
Practice Address - Phone:630-892-0606
Practice Address - Fax:630-761-3260
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL38007990111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL212717Medicare ID - Type Unspecified