Provider Demographics
NPI:1174629497
Name:KRAVARIK, JOHN STEPHAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:STEPHAN
Last Name:KRAVARIK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2808 ADOBE DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-2628
Mailing Address - Country:US
Mailing Address - Phone:815-609-9081
Mailing Address - Fax:
Practice Address - Street 1:2400 CATON FARM RD
Practice Address - Street 2:UNIT K
Practice Address - City:CREST HILL
Practice Address - State:IL
Practice Address - Zip Code:60435-1386
Practice Address - Country:US
Practice Address - Phone:815-609-9081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor