Provider Demographics
NPI:1609157155
Name:DAVILA, DANIEL (DC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:DAVILA
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 1:121 W HILLGROVE AVE UNIT 52
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-1002
Mailing Address - Country:US
Mailing Address - Phone:630-634-2942
Mailing Address - Fax:
Practice Address - Street 1:534 W CHESTNUT ST BSMT LEVEL
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3167
Practice Address - Country:US
Practice Address - Phone:630-425-4040
Practice Address - Fax:630-655-7425
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-011851111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor