Provider Demographics
NPI:1033482468
Name:HALFMAN, DANIEL M (DPT)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:M
Last Name:HALFMAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-8813
Mailing Address - Country:US
Mailing Address - Phone:630-575-1980
Mailing Address - Fax:
Practice Address - Street 1:2525 N ANKENY BLVD
Practice Address - Street 2:STE. 101
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-4714
Practice Address - Country:US
Practice Address - Phone:515-965-4594
Practice Address - Fax:515-965-4448
Is Sole Proprietor?:No
Enumeration Date:2012-02-15
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012004491225100000X
IA086073225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO150900052Medicare PIN