Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 038.012654 | IL |
N | 111NR0400X | Rehabilitation Chiropractor | 038.012654 | IL |
N | 111NS0005X | Chiropractic Sports Physician | 038.012654 | IL |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 038.012654 | IL |
NPI | 1174931141 |
---|---|
Provider Name | Dr. Daniel Han |
First Address | Des Plaines, IL 60016-1805 |
Second Address | Des Plaines, IL 60016-1805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2014 |
Last Update Date | 23/07/2014 |