Provider Demographics
NPI:1912109653
Name:YINGLING, STEVEN JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JOSEPH
Last Name:YINGLING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:245 W. ROOSEVELT RD
Mailing Address - Street 2:BUILDING 15, UNIT 104
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-4821
Mailing Address - Country:US
Mailing Address - Phone:630-393-4722
Mailing Address - Fax:630-393-4170
Practice Address - Street 1:245 W. ROOSEVELT RD
Practice Address - Street 2:BUILDING 15, UNIT 104
Practice Address - City:WEST CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60185-4821
Practice Address - Country:US
Practice Address - Phone:630-393-4722
Practice Address - Fax:630-393-4170
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL38010940111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL215239Medicare UPIN