Provider Demographics
NPI:1417007121
Name:MONAGHAN, DANIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:MONAGHAN
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 1:3301 RESOURCE PKWY STE 3
Mailing Address - Street 2:
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115-5334
Mailing Address - Country:US
Mailing Address - Phone:815-758-9999
Mailing Address - Fax:815-758-8220
Practice Address - Street 1:3301 RESOURCE PKWY STE 3
Practice Address - Street 2:
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-5334
Practice Address - Country:US
Practice Address - Phone:815-758-9999
Practice Address - Fax:815-758-8220
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2014-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008156111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0038008156Medicaid
ILL95452Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE
IL0038008156Medicaid