Provider Demographics
NPI:1659404119
Name:ZILKE, STEVEN ALAN
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ALAN
Last Name:ZILKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 S BUSINESS 54
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MO
Mailing Address - Zip Code:65251-1403
Mailing Address - Country:US
Mailing Address - Phone:573-642-9999
Mailing Address - Fax:
Practice Address - Street 1:710 S BUSINESS 54
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MO
Practice Address - Zip Code:65251-1403
Practice Address - Country:US
Practice Address - Phone:573-642-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO6346111N00000X
MOR1175225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO318800003Medicare PIN