Daniel L Cheatham, D.C.
Individual provider Active NPI Chiropractor · Ottawa, IL
NPI 1225010028 · NPPES record last updated Jun 23, 2014
Key facts
- NPI
- 1225010028
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 038-003927 (IL)
- Practice address
- 106 W McKinley Rd
Ottawa, IL 61350-4713 - Phone
- (815) 434-1616
- Fax
- (815) 434-1625
- NPI assigned
- Nov 17, 2005
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038-003927 | IL | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038-003927 | IL | Yes |
Addresses
Primary practice location
106 W McKinley Rd
Ottawa, IL 61350-4713
Mailing address
106 W McKinley Rd
Ottawa, IL 61350-4713
Phone (815) 434-1616
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5082014 | Other | IL | BLUE CROSS/BLUE SHIELD |
| 651463 | Other | IL | UNITED HEALTHCARE ACN |
| 791350930 | Other | IL | RAIL ROAD MEDICARE |
Other providers in Ottawa, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.