Stevens, Nathan A

Stevens, Nathan A is an individual health care provider with primary practice located at 600 West Main , Olney IL 62450-2623. He recently has only one registered license in Chiropractic Providers / Sports Physician, which is considered as his primary health care specialty. Stevens, Nathan A can be contacted via phone (618) 395-2225.

Contact Information

Primary practice address
600 West Main Olney IL 62450-2623
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Sports Physician 111NS0005X 038-008490 Illinois

Profile Details

NPI number 1114035896
LBN Legal business name Stevens, Nathan A
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2006
Last updated Jul 16th, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114035896 NPPES
Illinois Other 08022501 BLUE CROSS BLUE SHIELD
Illinois MEDICAID 038008490 BLUE CROSS BLUE SHIELD
Illinois Other 350044665 BLUE CROSS BLUE SHIELD

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