Provider Demographics
NPI:1417097734
Name:DAVID, DANNY MICHAEL (OD)
Entity type:Individual
Prefix:DR
First Name:DANNY
Middle Name:MICHAEL
Last Name:DAVID
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 N MEACHAM RD
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4805
Mailing Address - Country:US
Mailing Address - Phone:847-414-4233
Mailing Address - Fax:
Practice Address - Street 1:1375 N MEACHAM RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4805
Practice Address - Country:US
Practice Address - Phone:847-969-0959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.009923152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist