Provider Demographics
NPI:1336558022
Name:GOGGIN, DANIEL (ATC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:GOGGIN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2850 S WABASH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-2491
Mailing Address - Country:US
Mailing Address - Phone:312-842-4600
Mailing Address - Fax:312-842-8690
Practice Address - Street 1:2000 5TH AVE
Practice Address - Street 2:R-116
Practice Address - City:RIVER GROVE
Practice Address - State:IL
Practice Address - Zip Code:60171-1907
Practice Address - Country:US
Practice Address - Phone:708-456-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-06
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL096.0031562255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer