Gary R Stevens, D.C.
Individual provider Active NPI Chiropractor · Albion, IL
NPI 1013960145 · NPPES record last updated Sep 16, 2011
Key facts
- NPI
- 1013960145
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 0380041640 (IL)
- Practice address
- 21 W Main St
Albion, IL 62806-1006 - Phone
- (618) 445-2419
- NPI assigned
- May 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 0380041640 | IL | Yes |
Addresses
Primary practice location
21 W Main St
Albion, IL 62806-1006
Mailing address
21 W Main St
Albion, IL 62806-1006
Phone (618) 445-2419
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0380041640 | Medicaid | IL |
Other providers in Albion, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.