Provider Demographics
NPI:1528133790
Name:YOSS, STUART EVAN (DC, CCSP)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:EVAN
Last Name:YOSS
Suffix:
Gender:M
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 FOX RUN DR
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-1511
Mailing Address - Country:US
Mailing Address - Phone:847-498-1401
Mailing Address - Fax:
Practice Address - Street 1:2101 WAUKEGAN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BANNOCKBURN
Practice Address - State:IL
Practice Address - Zip Code:60015-1836
Practice Address - Country:US
Practice Address - Phone:847-236-1194
Practice Address - Fax:847-236-1195
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-007835111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL7855193OtherAETNA
IL49-22400OtherBLUE CROSS BLUE SHIELD
IL49-22400OtherBLUE CROSS BLUE SHIELD
IL7855193OtherAETNA