Provider Demographics
NPI:1477598316
Name:NOHAVA, STEPHEN PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:PAUL
Last Name:NOHAVA
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 1:1795 GRANDSTAND PL
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-4980
Mailing Address - Country:US
Mailing Address - Phone:847-888-3131
Mailing Address - Fax:847-888-3359
Practice Address - Street 1:1795 GRANDSTAND PL
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4980
Practice Address - Country:US
Practice Address - Phone:847-888-3131
Practice Address - Fax:847-888-3359
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.011217111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNU80510Medicare UPIN
MN350003463Medicare ID - Type Unspecified