Provider Demographics
NPI:1518227024
Name:DR DAN INC
Entity Type:Organization
Organization Name:DR DAN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:HIBBARD
Authorized Official - Last Name:MONAGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-758-9999
Mailing Address - Street 1:3301 RESOURCE PKWY
Mailing Address - Street 2:SUITE 3
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
Practice Address - Street 2:SUITE 3
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.008156111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty