Provider Demographics
NPI:1720888985
Name:HOSTETLER, DANIEL LEE (MNM, CADC, CODP I)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:LEE
Last Name:HOSTETLER
Suffix:
Gender:
Credentials:MNM, CADC, CODP I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 CRESTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-7708
Mailing Address - Country:US
Mailing Address - Phone:224-595-6192
Mailing Address - Fax:
Practice Address - Street 1:2020 CRESTWOOD LN
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-7708
Practice Address - Country:US
Practice Address - Phone:224-595-6192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL33626101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)