Provider Demographics
NPI:1891420097
Name:NOVAK, DANIEL A
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:A
Last Name:NOVAK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2483 ONEIDA LN
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-4038
Mailing Address - Country:US
Mailing Address - Phone:630-205-1872
Mailing Address - Fax:
Practice Address - Street 1:4300 WEAVER PKWY STE 100A
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3920
Practice Address - Country:US
Practice Address - Phone:630-416-8289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional