Individual
DANIEL BLAKE HELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 327-3042
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 327-3042
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
125.081007
IL
208600000X
Surgery Physician
125.081007
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2021
Last updated
05/13/2024
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