Provider Demographics
NPI:1023056611
Name:SIKORSKY, STEPHEN A (DC)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:A
Last Name:SIKORSKY
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 1:104 TYLER CREEK PLAZA
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123
Mailing Address - Country:US
Mailing Address - Phone:847-645-0464
Mailing Address - Fax:847-695-0461
Practice Address - Street 1:104 TYLER CREEK PLAZA
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123
Practice Address - Country:US
Practice Address - Phone:847-645-0464
Practice Address - Fax:847-695-0461
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008586111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0453210OtherBCBS
U83195Medicare UPIN
212903Medicare ID - Type Unspecified