Provider Demographics
NPI:1578709374
Name:KIRAN, DAYANAND (MS, PT)
Entity Type:Individual
Prefix:
First Name:DAYANAND
Middle Name:
Last Name:KIRAN
Suffix:
Gender:M
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W WACKER DR
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-1216
Mailing Address - Country:US
Mailing Address - Phone:312-640-0329
Mailing Address - Fax:
Practice Address - Street 1:16 W CARLETON RD
Practice Address - Street 2:SUITE 1
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-1226
Practice Address - Country:US
Practice Address - Phone:517-439-2376
Practice Address - Fax:517-439-2379
Is Sole Proprietor?:No
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501013654225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist