Provider Demographics
NPI:1770890527
Name:STEWART FAMILY CHIROPRACTIC LLC
Entity type:Organization
Organization Name:STEWART FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-676-3536
Mailing Address - Street 1:1406 SYCAMORE RD
Mailing Address - Street 2:STE B
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115-2063
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1406 SYCAMORE RD
Practice Address - Street 2:STE B
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-2063
Practice Address - Country:US
Practice Address - Phone:563-676-3536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-31
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty