Healthcare Provider Details

I. General information

NPI: 1558593483
Provider Name (Legal Business Name): DANIEL HONAN PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2009
Last Update Date: 02/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8337 W LAWRENCE AVE
NORRIDGE IL
60706-3129
US

IV. Provider business mailing address

600 OAKMONT LN STE 600C
WESTMONT IL
60559-5548
US

V. Phone/Fax

Practice location:
  • Phone: 708-583-9500
  • Fax: 708-583-9501
Mailing address:
  • Phone: 630-575-1980
  • Fax: 630-928-5080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070-017312
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: