Provider Demographics
NPI:1215598024
Name:BALIKOV, DANIEL (MD, PHD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:BALIKOV
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4822 S COTTAGE GROVE AVE STE 2-300
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60061
Mailing Address - Country:US
Mailing Address - Phone:312-695-8150
Mailing Address - Fax:312-921-1071
Practice Address - Street 1:4822 S COTTAGE GROVE AVE STE 2-300
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60061
Practice Address - Country:US
Practice Address - Phone:312-695-8150
Practice Address - Fax:312-921-1071
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME161907207W00000X
IL036176089207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology