Provider Demographics
NPI:1417025784
Name:ZAESKE, STEVEN W (DC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:W
Last Name:ZAESKE
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 1:18309 DISTINCTIVE DR
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-9461
Mailing Address - Country:US
Mailing Address - Phone:708-479-0020
Mailing Address - Fax:708-479-0094
Practice Address - Street 1:918 MADISON ST
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-4474
Practice Address - Country:US
Practice Address - Phone:630-920-4670
Practice Address - Fax:630-920-4687
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-02
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008716111NI0900X
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU80530Medicare UPIN