Provider Demographics
NPI:1316162449
Name:COFFEY, DANIEL F (DC BABCO ACRB)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:F
Last Name:COFFEY
Suffix:
Gender:M
Credentials:DC BABCO ACRB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 S MAIN STREET
Mailing Address - Street 2:SUITE E
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148
Mailing Address - Country:US
Mailing Address - Phone:630-916-8533
Mailing Address - Fax:630-916-8538
Practice Address - Street 1:310 S MAIN STREET
Practice Address - Street 2:SUITE E
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148
Practice Address - Country:US
Practice Address - Phone:630-916-8533
Practice Address - Fax:630-916-8538
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008821111NR0400X, 111NX0800X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02222824OtherBLUE CROSS BLUE SHIELD
IL02222824OtherBLUE CROSS BLUE SHIELD
IL703080Medicare ID - Type Unspecified