Provider Demographics
NPI:1609946300
Name:KVAAL, STEVEN ALLEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ALLEN
Last Name:KVAAL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:430 S MICHIGAN AVE
Mailing Address - Street 2:ROOSEVELT UNIVERSITY
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-1313
Mailing Address - Country:US
Mailing Address - Phone:312-341-6374
Mailing Address - Fax:312-341-6362
Practice Address - Street 1:2751 W WINONA ST
Practice Address - Street 2:SWEDISH COVENANT HOSPITAL
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-2508
Practice Address - Country:US
Practice Address - Phone:773-878-8200
Practice Address - Fax:773-907-3032
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILS18019Medicare UPIN
IL406900Medicare ID - Type Unspecified