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General NPI Number Information
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NPI Number | 1285136911
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Entity Type | Individual
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Provider Name | DANILO RIVERA KAYANAN JR.
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Gender | Male
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Dates
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Enumeration Date | 03/08/2018
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Last Update Date | 03/08/2018
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Provider Practice Location Address
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Address Line | 125 S MORGAN STREET
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City | RUSHVILLE
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State | IL
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Zip | 62681
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Country | US
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Telephone | 217-883-8736
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Fax |
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Provider Business Mailing Address
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Address Line | 537 MEADOW DR
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City | MACOMB
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State | IL
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Zip | 61455-9320
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Country | US
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Telephone | 309-966-5098
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 21365
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License Number State | IL
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