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DANIEL M PROVENCHER PA-C
NPI 1053426965
Physician Assistant - Medical in Hinsdale, IL

Active since August 20, 2006
911 N ELM ST, SUITE 128, HINSDALE, IL 60521(630) 789-2260(630) 789-1584 Get Directions Write a Review

NPPES record last updated: January 12, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Daniel M Provencher Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DANIEL M PROVENCHER PA-C (NPI 1053426965) is an individual medical provider in Hinsdale, Illinois, licensed in Illinois (085001850) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1053426965
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameDANIEL M PROVENCHERCredential: PA-C
Location Address911 N ELM ST, SUITE 128Hinsdale, IL 60521-3640
Mailing Address911 N Elm St, Suite 128Hinsdale, IL 60521-3640 · (630) 789-2260 · Fax (630) 789-1584
Phone(630) 789-2260
Fax(630) 789-1584
Sole ProprietorNo
Enumeration DateAugust 20, 2006
Last NPPES UpdateJanuary 12, 2012
✔ NPI 1053426965 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in IL · 085001850
911 N ELM ST, Hinsdale, IL 60521
Open in Google Maps ↗

Other Identifiers 3

Other362658747IL · Federal Tax Id
Medicare UPINP82238IL
Medicare ID-Type Unspecified497360IL · Group Provider Number

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARY E MCRAVEN PA-C
Physician Assistant
911 N ELM ST, SUITE 128
HINSDALE, IL 60521
Dupage County (630) 856-7460
DR. PAULA ELLEN MACHTINGER PH.D.
Psychologist (Clinical)
911 N ELM ST, SUITE 316
HINSDALE, IL 60521
Dupage County (708) 366-3620
DR. SUNEEL MAHENDRA UDANI M.D.
Internal Medicine (Nephrology)
911 N ELM ST, SUITE 102
HINSDALE, IL 60521
Dupage County (630) 495-9356
DR. RUTH BOUTIN KUNCEL PH.D.
Psychologist (Clinical)
911 N ELM ST, SUITE 320
HINSDALE, IL 60521
Dupage County (630) 325-4310
ROBERT A. BEATTY, M.D. S.C.
Specialist
911 N ELM ST, SUITE 114
HINSDALE, IL 60521
Dupage County (630) 986-8290
DR. DIANE G. KLEIBER DDS
Dentist (General Practice)
911 N ELM ST, SUITE 225
HINSDALE, IL 60521
Dupage County (630) 323-0060
DR. SAKINA TAPIA M.D.
Pediatrics
911 N ELM ST, SUITE 115
HINSDALE, IL 60521
Dupage County (630) 323-0890
MRS. LISA FORTMAN MD
Family Medicine
911 N ELM ST, SUITE 301
HINSDALE, IL 60521
Dupage County (630) 986-1420

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Daniel Provencher's NPI number?

The NPI number for Daniel Provencher is 1053426965. It was assigned to this individual provider in the NPPES registry on August 20, 2006.

Where is Daniel Provencher located?

Daniel Provencher practices at 911 N Elm St Suite 128, Hinsdale, IL 60521. The listed phone number is (630) 789-2260.

What is Daniel Provencher's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Daniel Provencher was last updated on January 12, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.