Provider Demographics
NPI:1457355034
Name:KNOERNSCHILD, STEVEN (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:KNOERNSCHILD
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 1:500 S ILLINOIS ST
Mailing Address - Street 2:STE 4
Mailing Address - City:MILLSTADT
Mailing Address - State:IL
Mailing Address - Zip Code:62260-1373
Mailing Address - Country:US
Mailing Address - Phone:618-476-3344
Mailing Address - Fax:618-476-7711
Practice Address - Street 1:500 S ILLINOIS ST
Practice Address - Street 2:STE 4
Practice Address - City:MILLSTADT
Practice Address - State:IL
Practice Address - Zip Code:62260-1373
Practice Address - Country:US
Practice Address - Phone:618-476-3344
Practice Address - Fax:618-476-7711
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009319111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL117583OtherGHP
IL0008227369OtherBLUE CROSS BLUE SHIELD
IL451565OtherHEALTHLINK
IL209074Medicare ID - Type Unspecified