Provider Demographics
NPI:1255752499
Name:HOUK, DANA N (DPT)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:N
Last Name:HOUK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MRS
Other - First Name:DANA
Other - Middle Name:
Other - Last Name:WALEROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:131 OLD FARM MID CT
Mailing Address - Street 2:
Mailing Address - City:BRADLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60915-1485
Mailing Address - Country:US
Mailing Address - Phone:815-953-6547
Mailing Address - Fax:815-614-2101
Practice Address - Street 1:141 N SCHUYLER AVE
Practice Address - Street 2:
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-3828
Practice Address - Country:US
Practice Address - Phone:815-614-2100
Practice Address - Fax:815-614-2101
Is Sole Proprietor?:No
Enumeration Date:2013-12-13
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.020151225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist