Provider Demographics
NPI:1225120876
Name:ZEVAN, ALEX III (DC, FIACA, DABCI)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:
Last Name:ZEVAN
Suffix:III
Gender:M
Credentials:DC, FIACA, DABCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6548
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-6548
Mailing Address - Country:US
Mailing Address - Phone:630-539-5822
Mailing Address - Fax:630-539-5823
Practice Address - Street 1:109 1ST ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1219
Practice Address - Country:US
Practice Address - Phone:630-539-5822
Practice Address - Fax:630-539-5823
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-007306111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL222-0421OtherBLUE CROSS/BLUE SHIELD
IL222-0421OtherBLUE CROSS/BLUE SHIELD