Provider Demographics
NPI:1174931141
Name:HAN, DANIEL (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:HAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9820 MILWAUKEE AVE # CD
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-1805
Mailing Address - Country:US
Mailing Address - Phone:773-999-9935
Mailing Address - Fax:
Practice Address - Street 1:9820 MILWAUKEE AVE
Practice Address - Street 2:UNIT C/D
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-1805
Practice Address - Country:US
Practice Address - Phone:773-999-9935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012654111N00000X, 111NR0400X, 111NS0005X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NX0800XChiropractic ProvidersChiropractorOrthopedic