Costa Jr, Daniel Jesse
Costa Jr, Daniel Jesse is an sole proprietor health care provider with primary practice located at 4315 Azalea Dr Suite 201, Lisle IL 60532-1181. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Costa Jr, Daniel Jesse can be contacted via phone (630) 717-8900.Contact Information
Primary practice address
4315 Azalea Dr Suite 201
Lisle IL 60532-1181
Phone: (630) 717-8900
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | Illinois |
Profile Details
| NPI number | 1932311149 |
|---|---|
| LBN Legal business name | Costa Jr, Daniel Jesse |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 3rd, 2007 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932311149 | NPPES |
| Illinois | Other | BLUECROSSBLUE SHIELD | GROUP # 02221920 |
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