Provider Demographics
NPI:1285978023
Name:SPEARSON, STEVEN C
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:C
Last Name:SPEARSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 MAY ST
Mailing Address - Street 2:PO BOX 132
Mailing Address - City:MANHATTAN
Mailing Address - State:IL
Mailing Address - Zip Code:60442-8548
Mailing Address - Country:US
Mailing Address - Phone:815-478-0405
Mailing Address - Fax:
Practice Address - Street 1:9624 S CICERO AVE
Practice Address - Street 2:323
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-3138
Practice Address - Country:US
Practice Address - Phone:815-478-0405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-17
Last Update Date:2012-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3000959253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care