Provider Demographics
NPI:1568454338
Name:ZASADNY, STEPHEN A (DC)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:A
Last Name:ZASADNY
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 1:10751 W 143RD ST
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-1900
Mailing Address - Country:US
Mailing Address - Phone:708-460-8688
Mailing Address - Fax:708-460-9272
Practice Address - Street 1:10751 W 143RD ST
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-1900
Practice Address - Country:US
Practice Address - Phone:708-460-8688
Practice Address - Fax:708-460-9272
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4656196OtherAETNA NON HMO
IL1001719OtherAETNA HMO
IL01682508OtherBLUE CROSS BLUE SHIELD
IL1001719OtherAETNA HMO
IL01682508OtherBLUE CROSS BLUE SHIELD