Provider Demographics
NPI:1699094979
Name:WHITE, STEVEN K (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:K
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 S MICHIGAN AVE
Mailing Address - Street 2:SUITE 1032-W702
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60604-4434
Mailing Address - Country:US
Mailing Address - Phone:630-319-7135
Mailing Address - Fax:630-622-1514
Practice Address - Street 1:332 S MICHIGAN AVE
Practice Address - Street 2:SUITE 1032-W702
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604-4434
Practice Address - Country:US
Practice Address - Phone:630-319-7135
Practice Address - Fax:630-622-1514
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-25
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036054020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine