MEDICARE: DR. DANIEL CHESTER LUBAN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	038-003744	IL

General Provider Information

NPI Number	:	1538169081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL CHESTER LUBAN DC

Provider Business Mailing Address
First Line	:	455 W FRONT ST
Second Line	:
City	:	EL PASO
State	:	IL
Zip	:	61738-1422
Country	:	US
Telephone Number	:	309-527-7551
Fax Number	:

Provider Business Practice Location Address
First Line	:	455 W FRONT ST
Second Line	:
City	:	EL PASO
State	:	IL
Zip	:	61738-1422
Country	:	US
Telephone Number	:	309-527-7551
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2005
Last Update Date	:	08/18/2014

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