Individual
DR. DANIEL L SYVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
11320 MAIN ST, SUITE 311, ROSCOE, IL 61073-4612
(815) 389-8088
(815) 389-3431
Mailing address
PO BOX 311, ROSCOE, IL 61073-0311
(815) 389-8088
(815) 389-3431
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
014004040
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016004040
—
IL
Enumeration date
12/08/2006
Last updated
01/29/2013
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