Individual
DANILO RIVERA KAYANAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
125 S MORGAN, STREET, RUSHVILLE, IL 62681
(217) 883-8736
Mailing address
537 MEADOW DR, MACOMB, IL 61455-9320
(309) 966-5098
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
21365
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K55017677298
DMV
IL
Enumeration date
03/08/2018
Last updated
03/08/2018
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