Provider Demographics
NPI:1831429059
Name:WALK, DANIEL L (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:L
Last Name:WALK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:PO BOX 826
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MAHOMET
Mailing Address - State:IL
Mailing Address - Zip Code:61853-0826
Mailing Address - Country:US
Mailing Address - Phone:217-586-2000
Mailing Address - Fax:866-586-3420
Practice Address - Street 1:1501 E OAK ST
Practice Address - Street 2:SUITE 2
Practice Address - City:MAHOMET
Practice Address - State:IL
Practice Address - Zip Code:61853-3751
Practice Address - Country:US
Practice Address - Phone:217-586-2000
Practice Address - Fax:831-851-2425
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-11
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL038011214111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor