Provider Demographics
NPI:1255656534
Name:SHEVOKAS, AMY ELAINE (DC)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:ELAINE
Last Name:SHEVOKAS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3649 N KEDZIE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-4513
Mailing Address - Country:US
Mailing Address - Phone:773-961-8970
Mailing Address - Fax:773-961-8951
Practice Address - Street 1:706 RIDGE RD
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1612
Practice Address - Country:US
Practice Address - Phone:219-836-8890
Practice Address - Fax:219-836-2344
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011662111N00000X
IN08002605A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor