Provider Demographics
NPI:1669666590
Name:DANIEL J. SWEENEY DC, LTD.
Entity type:Organization
Organization Name:DANIEL J. SWEENEY DC, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SWEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:708-385-5888
Mailing Address - Street 1:13807 CICERO AVE
Mailing Address - Street 2:
Mailing Address - City:CRESTWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60445-1826
Mailing Address - Country:US
Mailing Address - Phone:708-385-5888
Mailing Address - Fax:708-385-5925
Practice Address - Street 1:13807 CICERO AVE
Practice Address - Street 2:
Practice Address - City:CRESTWOOD
Practice Address - State:IL
Practice Address - Zip Code:60445-1826
Practice Address - Country:US
Practice Address - Phone:708-385-5888
Practice Address - Fax:708-385-5925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT37636Medicare UPIN
IL667750Medicare PIN