Provider Demographics
NPI:1700862315
Name:STEIN, AARON ALBERT (DC)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:ALBERT
Last Name:STEIN
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 1:800 DERBY ST
Mailing Address - Street 2:
Mailing Address - City:PEKIN
Mailing Address - State:IL
Mailing Address - Zip Code:61554-5847
Mailing Address - Country:US
Mailing Address - Phone:309-347-2587
Mailing Address - Fax:309-347-2587
Practice Address - Street 1:800 DERBY ST
Practice Address - Street 2:
Practice Address - City:PEKIN
Practice Address - State:IL
Practice Address - Zip Code:61554-5847
Practice Address - Country:US
Practice Address - Phone:309-347-2587
Practice Address - Fax:309-347-2587
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL09082017OtherBCBS OF IL
IL3424SOtherCAT INC
U54636Medicare UPIN
IL09082017OtherBCBS OF IL