Provider Demographics
NPI:1629163662
Name:BENKO, DANIEL JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOSEPH
Last Name:BENKO
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 1:142 W US HIGHWAY 30
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-1852
Mailing Address - Country:US
Mailing Address - Phone:219-322-9999
Mailing Address - Fax:219-322-9999
Practice Address - Street 1:142 W US HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-1852
Practice Address - Country:US
Practice Address - Phone:219-322-9999
Practice Address - Fax:219-322-9999
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001366111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL90000265OtherBLUE CROSS BLUE SHIELD
IN000000091026OtherBLUE CROSS/ANTHEM
INU39600Medicare UPIN
INBE404930Medicare ID - Type Unspecified