Individual
DR. DANIEL L CHEATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
106 W MCKINLEY RD, OTTAWA, IL 61350-4713
(815) 434-1616
(815) 434-1625
Mailing address
106 W MCKINLEY RD, OTTAWA, IL 61350-4713
(815) 434-1616
(815) 434-1625
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-003927
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5082014
BLUE CROSS/BLUE SHIELD
IL
01
—
651463
UNITED HEALTHCARE ACN
IL
01
—
791350930
RAIL ROAD MEDICARE
IL
Enumeration date
11/17/2005
Last updated
06/23/2014
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