Provider Demographics
NPI:1649363029
Name:HYNAN, DANIEL J (PHD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:HYNAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 81
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60522-0081
Mailing Address - Country:US
Mailing Address - Phone:630-455-1370
Mailing Address - Fax:630-455-0176
Practice Address - Street 1:200 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540
Practice Address - Country:US
Practice Address - Phone:630-455-1370
Practice Address - Fax:630-455-0176
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
280710OtherVALUE OPTIONS
IL0002273028OtherBCBS
950610Medicare ID - Type Unspecified