Provider Demographics
NPI:1699001578
Name:BALDINO, DANA R (DC)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:R
Last Name:BALDINO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2401 W US HIGHWAY 20
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PINGREE GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60140-8818
Mailing Address - Country:US
Mailing Address - Phone:847-453-4953
Mailing Address - Fax:847-453-4932
Practice Address - Street 1:2401 W US HIGHWAY 20
Practice Address - Street 2:SUITE 201
Practice Address - City:PINGREE GROVE
Practice Address - State:IL
Practice Address - Zip Code:60140-8818
Practice Address - Country:US
Practice Address - Phone:847-453-4953
Practice Address - Fax:847-456-4932
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-27
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-011528111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor