Individual
DANIEL E HOUGLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT ATC
Contact information
Practice address
15 COMMERCE DR, SUITE 106, GRAYSLAKE, IL 60030-7807
(847) 548-7782
(847) 548-7784
Mailing address
2998 MOMENTUM PL, CHICAGO, IL 60689-5329
(262) 657-0222
(262) 657-7190
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070011555
IL
225100000X
Physical Therapist
10070024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40394300
—
WI
01
—
859400057
MEDICARE
WI
01
—
IL6237013
MEDICARE
IL
01
—
IL6238013
MEDICARE
IL
01
—
IL6697006
MEDICARE
IL
Enumeration date
05/05/2006
Last updated
12/05/2015
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