Provider Demographics
NPI:1851419493
Name:MEDICAL ALTERNATIVES CORP
Entity Type:Organization
Organization Name:MEDICAL ALTERNATIVES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:VANDEN HOEK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-667-8864
Mailing Address - Street 1:2201 S BRENTWOOD BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BRENTWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63144-1847
Mailing Address - Country:US
Mailing Address - Phone:314-667-8864
Mailing Address - Fax:314-717-0010
Practice Address - Street 1:2201 S BRENTWOOD BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:BRENTWOOD
Practice Address - State:MO
Practice Address - Zip Code:63144-1847
Practice Address - Country:US
Practice Address - Phone:314-667-8864
Practice Address - Fax:314-717-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010163111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL541944OtherHEALTHLINK
MO178826OtherBCBS OF MO
MO541944OtherHEALTHLINK
IL9532009OtherBCBS OF ILLINOIS
MO178826OtherBCBS OF MO
MO000033304Medicare PIN
IL9532009OtherBCBS OF ILLINOIS