Individual
DANIEL MARTIN JURAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
935 E DIVISION ST, DIAMOND, IL 60416
(815) 634-8447
(815) 634-8612
Mailing address
114 W WAVERLY ST, MORRIS, IL 60450-1422
(815) 634-0529
(185) 634-0127
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036086918
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003220011
ILLINOIS BC/BS
IL
05
—
036086918
—
IL
Enumeration date
08/13/2006
Last updated
06/07/2018
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